Vila Ariza Beatriz, Carvajal Lopez Fernando, Negre Parra David, Daniela Parra Eslava Genesis, Uribe Quintana Natalia
Digestive Surgery, Centro de Estudios Universitarios (CEU) Cardenal Herrera University, Valencia, ESP.
Digestive Surgery, Hospital Arnau de Vilanova, Valencia, ESP.
Cureus. 2024 Oct 12;16(10):e71291. doi: 10.7759/cureus.71291. eCollection 2024 Oct.
Colonic lipomas are rare benign tumors that may appear throughout the entirety of the gastrointestinal tract, with a predisposition to appear in the colon. Patients with colonic lipoma are typically asymptomatic, making their diagnosis rare and incidental. This case report intends to investigate and clarify the decision-making process regarding surgical segmental colonic resection versus local excision via the study of a 48-year-old man with ulcerative colitis diagnosed in 2006, undergoing treatment with infliximab and without exacerbations since 2010. The patient presents with anal prolapse and colonic obstruction due to intussusception. After performing a CT scan with contrast, an intramural lipoma in the sigmoid colon measuring 5.5×4.7×4.6 cm was revealed. An elective oncologic sigmoid resection was the treatment of choice with regard to its size, location, and associated symptoms, especially when presenting complications like intussusception. Such a decision allowed for an improvement in pain control, shorter hospitalization, and faster recovery. The decision was also taken considering the safety risks regarding the size of the lesion and the presence of the intussusception.
结肠脂肪瘤是一种罕见的良性肿瘤,可出现在整个胃肠道,其中以结肠部位更为常见。患有结肠脂肪瘤的患者通常没有症状,因此其诊断较为罕见且多为偶然发现。本病例报告旨在通过对一名48岁男性患者的研究,探讨并阐明手术节段性结肠切除与局部切除的决策过程。该患者于2006年被诊断为溃疡性结肠炎,自2010年起接受英夫利昔单抗治疗且病情未再加重。患者因肠套叠出现肛门脱垂和结肠梗阻。在进行增强CT扫描后,发现乙状结肠有一个大小为5.5×4.7×4.6 cm的壁内脂肪瘤。鉴于其大小、位置及相关症状,尤其是出现肠套叠等并发症时,择期肿瘤性乙状结肠切除术是首选的治疗方法。这样的决策有助于改善疼痛控制、缩短住院时间并加快康复。做出该决策还考虑了病变大小和肠套叠存在所带来的安全风险。