Yamagishi Shunsuke, Kang Woodae, Shindate Masataka, Matsuno Yoritaka, Yoshida Masahiro, Kochi Mitsugu
Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, Ichikawa Hospital, International University of Health and Welfare School of Medicine, Chiba, Japan.
Department of Hemodialysis and Surgery, Ichikawa Hospital, International University of Health and Welfare School of Medicine, Chiba, Japan.
Case Rep Gastroenterol. 2024 Jul 25;18(1):373-378. doi: 10.1159/000540074. eCollection 2024 Jan-Dec.
Small bowel bleeding is being diagnosed with increasing frequency with the development of capsule endoscopy.
We report a case of lipoma that caused hematochezia in an 80-year-old woman with ischemic heart disease receiving antiplatelet therapy and on hemodialysis for renal failure. Contrast-enhanced computed tomography scans, esophagogastroduodenoscopy, and colonoscopy failed to identify the source of hematochezia. Capsule endoscopy revealed a small bowel tumor, which was removed through laparoscopic surgery without interruption of antiplatelet agents. The small bowel tumor was pathologically diagnosed as a lipoma. There was no recurrence of the hematochezia after surgery.
Lipomas could cause hematochezia. With appropriate preoperative testing, comorbidity assessment, and surgical planning, we believe that surgical resection is a safe treatment option for the removal of small bowel lipomas even in patients who are on hemodialysis or are taking antiplatelet agents.
随着胶囊内镜技术的发展，小肠出血的诊断频率日益增加。
我们报告一例脂肪瘤病例，该病例发生在一名80岁患有缺血性心脏病且正在接受抗血小板治疗并因肾衰竭接受血液透析的女性患者身上，导致便血。增强计算机断层扫描、食管胃十二指肠镜检查和结肠镜检查均未能确定便血的来源。胶囊内镜检查发现一个小肠肿瘤，通过腹腔镜手术将其切除，期间未中断抗血小板药物治疗。小肠肿瘤经病理诊断为脂肪瘤。术后便血未复发。
脂肪瘤可导致便血。通过适当的术前检查、合并症评估和手术规划，我们认为即使对于正在接受血液透析或服用抗血小板药物的患者，手术切除也是一种安全的治疗选择，用于切除小肠脂肪瘤。
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