George Papouis S, Pegios Athanasios G, Georgakis Ioannis Ch, Petridou Maria I, Limas Christos M
Department of Pediatric Surgery, Hippokratio Hospital, Thessaloniki, Greece.
Department of Pediatric Surgery, University General Hospital of Alexandroupolis, Alexandroupoli, Greece.
J Indian Assoc Pediatr Surg. 2022 Nov-Dec;27(6):768-770. doi: 10.4103/jiaps.jiaps_33_22. Epub 2022 Nov 14.
Colonic lipomas, even though rare, are the most common intramural tumor and the second-most common benign tumor of the colon after adenomatous polyps. We present the case of a 4-year-old boy with a large rectal lipoma causing anal prolapse, bleeding, and constipation, to discuss differential diagnostic problems and the proper management. A 4-year-old boy presented with symptoms of anal prolapse and constipation. Anal prolapse was accompanied by a tumor that occasionally was bleeding. Computed tomography was performed to determine the origin of the tumor and its relations with the surrounding tissues. Excision of the mass was performed through retraction through the anus and the anal wall was closed with sutures. Histopathological findings revealed a submucosal lipoma of a 5 cm diameter, with the erosions of the overlying mucosa. The patient was discharged after 3 days with no postoperative complications. Colonic lipomas, even though rare, are the second-most common benign tumor of the colon. Essential reasons for the resection are the potential complications, such as abdominal pain, change in bowel pattern, bleeding, obstruction, intussusception, perforation, and rarely transformation into a liposarcoma. Resection is performed endoscopically if the tumor is <2 cm in diameter and has a narrow base that allows safe ligation. Otherwise, the open procedure should be considered. In our case, prolapse of the mass through the anal canal allowed the transanal resection.
结肠脂肪瘤虽然罕见，但却是最常见的壁内肿瘤，也是继腺瘤性息肉后结肠第二常见的良性肿瘤。我们报告一例4岁男孩，患有巨大直肠脂肪瘤，导致肛门脱垂、出血和便秘，以讨论鉴别诊断问题及恰当的处理方法。一名4岁男孩出现肛门脱垂和便秘症状。肛门脱垂伴有一个偶尔出血的肿物。进行了计算机断层扫描以确定肿物的起源及其与周围组织的关系。通过经肛门牵拉切除肿物，并用缝线缝合肛门壁。组织病理学检查结果显示为一个直径5厘米的黏膜下脂肪瘤，其上方黏膜有糜烂。患者术后3天出院，无术后并发症。结肠脂肪瘤虽然罕见，但却是结肠第二常见的良性肿瘤。切除的主要原因是可能出现的并发症，如腹痛、排便习惯改变、出血、梗阻、肠套叠、穿孔，以及罕见的转变为脂肪肉瘤。如果肿瘤直径<2厘米且基底部狭窄允许安全结扎，则可通过内镜进行切除。否则，应考虑开放手术。在我们的病例中，肿物经肛管脱垂使得能够经肛门切除。
