Ejtehadi Farshid, Mohammed Elsamoual, Vijay Vardhini
Department of Colorectal Surgery, The Princess Alexandra Hospital NHS Trust, Harlow, UK.
J Surg Case Rep. 2020 Aug 24;2020(8):rjaa297. doi: 10.1093/jscr/rjaa297. eCollection 2020 Aug.
Colonic lipomas are the most widespread non-epithelial tumours of the large bowel. They often present with absent, non-specific or intermittent symptoms. Intussusception is the most common complication that may occur as a result of such a lesion. We present the case of a young female patient with a history of intermittent abdominal pain associated with nausea. She presented to the emergency department with subacute large bowel obstruction. A diagnosis of colo-colic intussusception due to a large descending colonic lipoma was confirmed on CT scan. The patient underwent a laparoscopic assisted submucosal excision of the lipoma. We discuss this unique operative technique as well as preoperative investigations and histopathology findings. Although successful endoscopic excision of lipomas has been reported, segmental resection of the colon is most commonly practiced. To the best of our knowledge, this is the first report of laparoscopic assisted submucosal excision of an intussuscepting colonic lipoma.
结肠脂肪瘤是大肠最常见的非上皮性肿瘤。它们通常表现为无症状、非特异性或间歇性症状。肠套叠是由此类病变可能导致的最常见并发症。我们报告一例年轻女性患者，有间歇性腹痛伴恶心病史。她因亚急性大肠梗阻就诊于急诊科。CT扫描确诊为降结肠巨大脂肪瘤导致的结肠-结肠套叠。患者接受了腹腔镜辅助下脂肪瘤黏膜下切除术。我们讨论了这种独特的手术技术以及术前检查和组织病理学结果。尽管已有脂肪瘤内镜下切除成功的报道，但结肠节段性切除仍是最常用的方法。据我们所知，这是首例关于腹腔镜辅助下套叠性结肠脂肪瘤黏膜下切除术的报告。
