Dohmoto Yu, Akashi Yoshimasa, Ogawa Koichi, Enomoto Tsuyoshi, Ohara Yusuke, Owada Yohei, Oda Tatsuya
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
J Med Case Rep. 2024 Apr 22;18(1):200. doi: 10.1186/s13256-024-04511-5.
Lipomas arising in the parietal peritoneum are rare, and some of them cause abdominal pain due to torsion of the pedunculated peritoneum. We encountered a case of parietal peritoneal lipoma arising upper peritoneum. In this report, we describe the detail of clinical presentation and discuss its potential pathogenesis and treatment strategy.
45 year-old Japanese female patient presented with long-lasting intermittent pain in the left upper abdominal region. Abdominal imaging showed a well-defined fatty mass measuring 40 mm in size, suggesting a parietal peritoneal lipoma. Laparoscopy revealed a tumor with a twisted peduncle; however, no adhesion of the surrounding tissues and ischemic changes were visible. The tumor was easily removed by dissection of the tumor pedicle.
Parietal peritoneal lipoma often shows pedunculated form and it causes abdominal pain by the torsion of tumor pedicle. Therefore, this type of lipoma should be considered a more aggressive surgery.
起源于壁层腹膜的脂肪瘤较为罕见，其中一些因带蒂腹膜扭转而导致腹痛。我们遇到了一例起源于上腹膜的壁层腹膜脂肪瘤病例。在本报告中，我们描述了临床表现的细节，并讨论了其潜在的发病机制和治疗策略。
一名45岁的日本女性患者出现左上腹长期间歇性疼痛。腹部影像学检查显示一个边界清晰的脂肪性肿块，大小为40毫米，提示为壁层腹膜脂肪瘤。腹腔镜检查发现一个带蒂扭转的肿瘤；然而，周围组织未见粘连和缺血改变。通过分离肿瘤蒂，肿瘤很容易被切除。
壁层腹膜脂肪瘤常呈带蒂形态，可因肿瘤蒂扭转引起腹痛。因此，对于这类脂肪瘤应考虑采取更积极的手术治疗。
