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腹腔镜下切除巨大上消化道出血后胃脂肪瘤:一例报告

Laparoscopic resection of a gastric lipoma following massive upper gastrointestinal bleeding: A case report.

作者信息

Chaouch Mohamed Ali, Taieb Ahmed Hadj, Maaref Mohamed, Baccari Louay, Saad Jamal, Noomen Faouzi

机构信息

Department of Visceral and Digestive, Monastir University Hospital, Monastir, Tunisia.

Department of Visceral and Digestive, Monastir University Hospital, Monastir, Tunisia.

出版信息

Int J Surg Case Rep. 2024 Jul;120:109876. doi: 10.1016/j.ijscr.2024.109876. Epub 2024 Jun 6.

Abstract

IMPORTANCE AND BACKGROUND

Gastric lipomas are rare submucosal tumours that account for less than 1 % of all stomach tumours. Despite their benign nature, they can lead to significant clinical manifestations such as gastric outlet obstruction and massive gastrointestinal haemorrhage.

CASE PRESENTATION

We report the case of a 50-year-old woman with no prior comorbidities, presenting with severe upper gastrointestinal bleeding. Diagnostic imaging and endoscopy identified a submucosal mass in the prepyloric area, later confirmed to be a gastric lipoma. The surgical intervention involved laparoscopic resection of the mass.

DISCUSSION

This case underscores the importance of considering gastric lipomas in differential diagnoses of gastrointestinal bleeding. While often asymptomatic, their potential to cause acute complications necessitates awareness among clinicians. The management strategies range from observational approaches in asymptomatic cases to surgical excision in symptomatic cases.

CONCLUSIONS

Gastric lipomas, though rare and often benign, can present with life-threatening complications. Accurate diagnosis using a combination of endoscopy and imaging, particularly CT scans, is critical for effective management. Surgical removal remains the definitive treatment for symptomatic lipomas, highlighting the need for a tailored approach based on the tumour's characteristics and location.

摘要

重要性及背景

胃脂肪瘤是罕见的黏膜下肿瘤,占所有胃肿瘤的比例不到1%。尽管其本质为良性,但可导致显著的临床表现,如胃出口梗阻和大量胃肠道出血。

病例介绍

我们报告一例50岁无既往合并症的女性,表现为严重上消化道出血。诊断性影像学检查和内镜检查发现幽门前区有一黏膜下肿块,后来证实为胃脂肪瘤。手术干预包括腹腔镜下切除该肿块。

讨论

该病例强调了在胃肠道出血的鉴别诊断中考虑胃脂肪瘤的重要性。虽然胃脂肪瘤通常无症状,但其引发急性并发症的可能性要求临床医生予以关注。管理策略从无症状病例的观察方法到有症状病例的手术切除。

结论

胃脂肪瘤虽然罕见且通常为良性,但可出现危及生命的并发症。联合使用内镜检查和影像学检查,尤其是CT扫描进行准确诊断,对于有效管理至关重要。手术切除仍然是有症状脂肪瘤的确定性治疗方法,这突出了需要根据肿瘤的特征和位置采取定制化方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d65/11226956/bc49a4812b5b/gr1.jpg

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