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结肠脂肪瘤,一种罕见的肠套叠病因:叙述性综述及诊断方法。

Colonic lipoma, a rare cause of intestinal intussusception: A narrative review and how to diagnose it.

机构信息

Department of Medicine and Ageing Sciences, University "G. D'Annunzio" of Chieti-Pescara, Pescara, Italy.

Department of Primary Care, A.S.P. Potenza, Potenza, Italy.

出版信息

Medicine (Baltimore). 2024 Sep 27;103(39):e39579. doi: 10.1097/MD.0000000000039579.

Abstract

Colonic lipomas (CLs) are benign tumors of the adipose tissue of the gastrointestinal tract that are often asymptomatic. A search of medical literature in English using PubMed and Google Scholar was conducted for articles related to CL. Occasionally, patients present with intestinal bleeding or obstructive symptoms. Although intussusception is commonly observed in children, it is rare in adults. Moreover, CL as the most common entity, is very rare, with an incidence rate of 0.035% to 4.4%. Although fatty composition can assist in diagnosis through computed tomography and magnetic resonance imaging, the latter cannot exclude local infiltration. CLs are distributed evenly between both sexes and can be located anywhere in the gastrointestinal tract; however, they are more frequently located in the colon, particularly in the right colon and cecum (39.6%), followed by the transverse colon (25%), descending colon (20.8%), and the sigmoid colon (14.6%). Symptoms included abdominal pain (79.2%), alterations in bowel habits (45.8%), rectal bleeding (22.9%), colocolic intussusception (50%), weight loss (6.2%), vomiting (14.6%), and nausea (12.5%). Surgical and endoscopic techniques are widely used to manage CLs. The challenge for physicians is differentiating this lesion from malignant colonic lesions, at the outset. The risk of misdiagnosis is possible, and the recommendation in cases of doubt is still segmental surgical resection, as it ensures correct collection of lymph nodes for appropriate staging of presumed colonic carcinoma.

摘要

结肠脂肪瘤(CL)是胃肠道脂肪组织的良性肿瘤,通常无症状。通过 PubMed 和 Google Scholar 对英文医学文献进行了检索,以查找与 CL 相关的文章。偶尔,患者会出现肠道出血或梗阻症状。虽然肠套叠在儿童中很常见,但在成人中却很少见。此外,以 CL 为最常见的实体瘤,发病率非常低,为 0.035%至 4.4%。虽然脂肪成分可以通过计算机断层扫描和磁共振成像协助诊断,但后者不能排除局部浸润。CL 均匀分布于两性,可位于胃肠道的任何部位;但更常位于结肠,特别是右半结肠和盲肠(39.6%),其次是横结肠(25%)、降结肠(20.8%)和乙状结肠(14.6%)。症状包括腹痛(79.2%)、排便习惯改变(45.8%)、直肠出血(22.9%)、结肠-结肠套叠(50%)、体重减轻(6.2%)、呕吐(14.6%)和恶心(12.5%)。外科和内镜技术广泛用于治疗 CL。对于医生来说,挑战在于在一开始就将这种病变与恶性结肠病变区分开来。误诊的风险是可能的,在有疑问的情况下,仍然建议进行节段性手术切除,因为它可以确保正确收集淋巴结,以对疑似结肠癌进行适当分期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb40/11441952/0303f8300a41/medi-103-e39579-g001.jpg

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