Kumar Kaitlin, Noori Mahboub R, Patel Kishan M, Yuen William, Bello Carlos
Florida International University, 11200 SW8 8th Street, Miami, FL, 33199, United States.
Int J Surg Case Rep. 2017;39:339-342. doi: 10.1016/j.ijscr.2017.08.038. Epub 2017 Sep 1.
Intestinal Lipomatosis consists of diffuse lipomas in various regions from the small to large bowel. They can remain asymptomatic or present with complications such as Intussusception.
Intestinal lipomatosis complicated by Intussusception is a rare occurrence that has not been well documented. Rare condition management is difficult to approach because of the customizability each scenario requires. We hope through sharing our approach this can serve as a rough template to physicians who find themselves in a similar scenario. Overtime, as more case reports and surgical approaches are recorded we can establish future advancements in surgery.
We present the case of a 47 year-old male who arrived at the Emergency Department with a chief complaint of abdominal pain. A CT scan revealed ileocolic intussusception. An intramural lipoma of the terminal ileum served as the lead point. Exploratory laparotomy confirmed the Intussusception and a right hemicolectomy was performed to repair the affected area. Examination of the resected large bowel showed diffuse thickening of the mucosa in the area of the cecum confirmed to be submucosal lipomatosis on histological examination. Patient was discharged on the fifth post-operative day.
This case confirmed previous treatment modalities in the management of intussusception. It also corroborates the complication of intussusception with Intestinal lipomatosis. It teaches us the importance of keeping a wide differential when considering a diagnosis of bowel obstruction. Through imaging, surgical exploration, and pathological interpretation, this case, which began as a complaint of abdominal pain, concluded as a rare clinical entity.
肠道脂肪瘤病由从小肠到大肠不同部位的弥漫性脂肪瘤组成。它们可能无症状，或表现为诸如肠套叠等并发症。
肠道脂肪瘤病合并肠套叠是一种罕见情况，文献记载较少。由于每种情况都需要个性化处理，罕见病症的管理难以进行。我们希望通过分享我们的处理方法，能为处于类似情况的医生提供一个大致模板。随着时间推移，当记录更多病例报告和手术方法时，我们可以在手术方面取得未来的进展。
我们介绍一例47岁男性患者，因腹痛为主诉就诊于急诊科。CT扫描显示回结肠套叠。末端回肠壁内脂肪瘤作为套叠的起始点。剖腹探查证实了肠套叠，并进行了右半结肠切除术以修复受影响区域。对切除的大肠进行检查显示，盲肠区域黏膜弥漫性增厚，组织学检查证实为黏膜下脂肪瘤病。患者术后第五天出院。
本病例证实了先前肠套叠治疗方式。它也证实了肠套叠与肠道脂肪瘤病的并发症。它让我们认识到在考虑肠梗阻诊断时保持广泛鉴别诊断的重要性。通过影像学、手术探查和病理解读，这个以腹痛主诉开始的病例最终诊断为一种罕见的临床实体。
