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导致胃肠道出血的空肠溃疡性脂肪瘤:一例报告

Ulcerated Jejunal Lipoma Causing Gastrointestinal Bleeding: A Case Report.

作者信息

Almeida Maria L, Costa Marcus, Bezerra Regueira Tatiana, Prince Franzini Tomazo, Secchi Thiago F, Oliveira Rafaela F, Ferreira Ana Laura O, Carpanetti Isabella

机构信息

Endoscopy, Hospital Nove de Julho, São Paulo, BRA.

Gastrointestinal Endoscopy, Hospital Nove de Julho, São Paulo, BRA.

出版信息

Cureus. 2024 Nov 11;16(11):e73446. doi: 10.7759/cureus.73446. eCollection 2024 Nov.

Abstract

Lipomas of the small intestine are rare and generally asymptomatic. However, they can present with obstructive symptoms or gastrointestinal bleeding that is difficult to localize. A 63-year-old female patient was admitted to the emergency department with a complaint of melena for four days. Endoscopy and colonoscopy were performed without any abnormalities. The patient showed no further externalization of symptoms and had a suspicion of intussusception on a CT scan. A capsule endoscopy was performed, revealing an elevated and ulcerated lesion in the proximal jejunum near the Treitz angle. An attempt at enteroscopy was made, but it was suspended due to gastric stasis. The patient developed obstructive symptoms and underwent exploratory laparotomy, which required enterectomy. The histopathological examination confirmed that the lesion was an ulcerated lipoma. Lipomas of the small intestine are rare and challenging to diagnose. The use of capsule endoscopy and enteroscopy allows for the diagnosis of these lesions, greater accuracy in localization, and, in some cases, treatment.

摘要

小肠脂肪瘤很罕见,通常无症状。然而,它们可能会出现梗阻症状或难以定位的胃肠道出血。一名63岁女性患者因黑便四天主诉入院急诊科。进行了内镜检查和结肠镜检查,未发现任何异常。患者症状未进一步外化,CT扫描怀疑有肠套叠。进行了胶囊内镜检查,发现屈氏韧带附近的空肠近端有一个隆起且溃疡的病变。尝试进行小肠镜检查,但由于胃潴留而中止。患者出现梗阻症状并接受了剖腹探查术,术中需要进行肠切除术。组织病理学检查证实该病变为溃疡型脂肪瘤。小肠脂肪瘤罕见且诊断具有挑战性。使用胶囊内镜和小肠镜可诊断这些病变,定位更准确,在某些情况下还可进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a99/11634554/f1bf363ee713/cureus-0016-00000073446-i01.jpg

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