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弥漫性结节性回肠和肠系膜脂肪瘤病引起的慢性腹胀:一例报告。

Chronic abdominal distention caused by diffuse nodular ileal and mesenteric lipomatosis: A case report.

机构信息

Department of Gastrointestinal Surgery, Hebei General Hospital, Shijiazhuang, Hebei, China.

Department of Gynecology, Hebei General Hospital, Shijiazhuang, Hebei, China.

出版信息

Medicine (Baltimore). 2024 Aug 2;103(31):e39171. doi: 10.1097/MD.0000000000039171.

Abstract

RATIONALE

Diffuse intestinal and mesenteric lipomatosis is a rare condition characterized by the overgrowth of adipose tissue in the intestines and mesentery. This case report aims to highlight the rare occurrence of chronic abdominal distention caused by this disease and its unique invasion into the muscle layer, which has not been previously reported.

PATIENT CONCERNS

A 36-year-old woman with a 7-year history of abdominal distension was admitted to our hospital's Department of Gastrointestinal Surgery.

DIAGNOSE

Abdominal and pelvic computed tomography revealed diffuse small intestinal lipomatosis.

INTERVENTIONS

The patient underwent surgery. We performed an open-field ilectomy involving removal of all lipomatous intestines (250 cm).

OUTCOMES

During the surgery, diffuse nodular ileal and mesenteric lipomatosis was confirmed, characterized by the presence of multiple nodular lipomas within the submucosal and muscular layers. The surgical intervention involved the resection of 250 cm of the affected ileum, followed by jejunoileal anastomosis. Postoperative pathology confirmed the diagnosis, with lesions observed in both the submucosa and muscle layers. The patient showed significant improvement in symptoms, with normal intestinal function and weight gain observed over a 10-month follow-up period, and no signs of recurrence.

LESSONS

Diffuse intestinal and mesenteric lipomatosis can lead to long-term abdominal distension. Additionally, it may be involved in the muscle layer of the intestinal wall. Surgery is the primary treatment option for symptomatic intestinal lipomatosis.

摘要

背景

弥漫性肠和肠系膜脂肪瘤病是一种罕见的疾病,其特征是肠和肠系膜内脂肪组织过度生长。本病例报告旨在强调这种疾病引起的慢性腹胀的罕见发生及其独特的侵犯肌层,这在以前的报道中尚未提及。

患者关注

一名 36 岁女性,腹胀病史 7 年,就诊于我院胃肠外科。

诊断

腹部和盆腔 CT 显示弥漫性小肠脂肪瘤病。

干预措施

患者接受了手术。我们进行了开放性回肠切除术,切除所有脂肪肠(250cm)。

结果

术中证实弥漫性结节状回肠和肠系膜脂肪瘤病,表现为黏膜下和肌层内存在多个结节状脂肪瘤。手术干预包括切除 250cm 受累回肠,然后进行空肠回肠吻合。术后病理证实了诊断,黏膜下和肌层均有病变。患者症状显著改善,在 10 个月的随访期间,肠道功能正常,体重增加,无复发迹象。

教训

弥漫性肠和肠系膜脂肪瘤病可导致长期腹胀,还可能侵犯肠壁的肌层。手术是治疗有症状的肠脂肪瘤病的主要选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cc0/11296449/d6dbaa11efb4/medi-103-e39171-g001.jpg

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