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巨大网膜脂肪瘤,成人右下腹疼痛的罕见病因:一例手术病例报告

Giant omental lipoma, a rare etiology of right-iliac fossa pain in adult: A surgical case report.

作者信息

Saleem Athary, Alfadhli Jumana, Alawadhi Abrar, Hassan Maher, Alshammari Khaled

机构信息

Department of General Surgery, Al-Adan Hospital, Kuwait.

Department of General Surgery, Al-Adan Hospital, Kuwait.

出版信息

Int J Surg Case Rep. 2022 Aug;97:107428. doi: 10.1016/j.ijscr.2022.107428. Epub 2022 Jul 23.

Abstract

BACKGROUND

Omental lipoma is an uncommon abdominal tumor of mature fat cells. Those benign tumors are usually asymptomatic but occasionally can cause signs and symptoms based on their location, size, and presence of complications. Radiological investigations such as Abdominal ultrasonography (USG) and computed tomography (CT) are crucial to evaluate and diagnose intra-abdominal tumors, especially omental lipomas.

PRESENTATION

A 61-year-old male patient presented to our hospital with right iliac fossa pain. Physical examination and laboratory test results were normal. The performed abdominal CT scan revealed a large right-sided intraperitoneal mass measuring about 2.4 × 10 × 20 cm. Then, an ultrasound-guided biopsy was done and the picture was most consistent with lipoma. So, surgical intervention was decided and omental lipoma was completely exteriorized via a laparoscopic approach. The weight of the excised omental mass was 2.45 kg, measuring 23 × 18 × 7 cm. The resected specimens, including omental lipoma and omental lymph nodes, were sent for histopathological studies. The postoperative period was uneventful.

DISCUSSION

Omental lipoma is an unusual entity that occurs often in children and rarely in adults. The clinical features of omental lipomas include abdominal discomfort, abdominal lump, abdominal pain, nausea, and/or weight loss. Diagnosis of the omental lipoma relies on imaging and physical examination, which was normal in the presented case. Abdominal CT provides definitive fat content characterization and its localization within the omentum.

CONCLUSION

Due to the rare etiologic origin of omental lipomas, we report the case of a 61-year-old male with right iliac fossa pain, found to be caused by detected giant omental lipoma.

摘要

背景

网膜脂肪瘤是一种由成熟脂肪细胞构成的罕见腹部肿瘤。这些良性肿瘤通常无症状,但偶尔会因肿瘤的位置、大小及有无并发症而引发体征和症状。腹部超声(USG)和计算机断层扫描(CT)等影像学检查对于评估和诊断腹内肿瘤,尤其是网膜脂肪瘤至关重要。

病例介绍

一名61岁男性患者因右下腹疼痛前来我院就诊。体格检查和实验室检查结果均正常。所进行的腹部CT扫描显示右侧腹腔内有一巨大肿块,大小约为2.4×10×20厘米。随后,在超声引导下进行了活检,结果显示最符合脂肪瘤表现。因此,决定进行手术干预,通过腹腔镜手术将网膜脂肪瘤完整切除。切除的网膜肿块重量为2.45千克,大小为23×18×7厘米。切除的标本,包括网膜脂肪瘤和网膜淋巴结,被送去做组织病理学研究。术后恢复顺利。

讨论

网膜脂肪瘤是一种不常见的疾病,常见于儿童,成人中较为罕见。网膜脂肪瘤的临床特征包括腹部不适、腹部肿块、腹痛、恶心和/或体重减轻。网膜脂肪瘤的诊断依赖于影像学检查和体格检查,本病例中体格检查结果正常。腹部CT能够明确脂肪成分特征及其在网膜内的定位。

结论

由于网膜脂肪瘤病因罕见,我们报告了一例61岁男性因右侧髂窝疼痛,经检查发现是由巨大网膜脂肪瘤所致的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae74/9403168/c6a15b82d5b6/gr1.jpg

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