小肠脂肪瘤致隐匿性胃肠道出血1例报告
Obscure gastrointestinal bleeding caused by small intestinal lipoma: a case report.
作者信息
Yatagai Noboru, Ueyama Hiroya, Shibuya Tomoyoshi, Haga Keiichi, Takahashi Masahito, Nomura Osamu, Sakamoto Naoto, Osada Taro, Yao Takashi, Watanabe Sumio
机构信息
Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
Department of Human Pathology, Juntendo University, School of Medicine, Tokyo, Japan.
出版信息
J Med Case Rep. 2016 Aug 12;10(1):226. doi: 10.1186/s13256-016-1014-4.
BACKGROUND
Small intestinal lipomas are rare, usually asymptomatic, and most commonly encountered incidentally during investigation of the gastrointestinal tract for another reason. However, they may cause obscure gastrointestinal bleeding.
CASE PRESENTATION
We report a case of obscure gastrointestinal bleeding due to a small intestinal lipoma. A 69-year-old Japanese man on antiplatelet therapy presented to our department with tarry stools and anemic symptoms. A small intestinal tumor was detected by capsule endoscopy and double-balloon endoscopy. After laparoscopic resection, the tumor was confirmed to be a lipoma.
CONCLUSIONS
Small intestinal lipomas are difficult to detect by conventional modalities, but capsule endoscopy and double-balloon endoscopy are good modalities for the diagnosis of small intestinal lipomas. Treatment of small intestinal lipomas should be selected carefully, considering the tumor size, size of stalk, administration of antithrombotic therapy, and endoscopic operability.
背景
小肠脂肪瘤罕见，通常无症状，最常见于因其他原因对胃肠道进行检查时偶然发现。然而，它们可能导致不明原因的胃肠道出血。
病例报告
我们报告一例因小肠脂肪瘤导致不明原因胃肠道出血的病例。一名正在接受抗血小板治疗的69岁日本男性因黑便和贫血症状就诊于我院。通过胶囊内镜和双气囊内镜检查发现小肠肿瘤。经腹腔镜切除后，肿瘤被确诊为脂肪瘤。
结论
小肠脂肪瘤难以通过传统方法检测，但胶囊内镜和双气囊内镜是诊断小肠脂肪瘤的良好方法。小肠脂肪瘤的治疗应根据肿瘤大小、蒂的大小、抗血栓治疗的使用情况以及内镜可操作性仔细选择。
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