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经肛门直肠脱垂脂肪瘤切除术:1例罕见病例报告

Transanal Resection of a Prolapsed Rectal Lipoma: A Report of a Rare Case.

作者信息

Arab Nahlah S, Alkhatabi Rawan K, Alhalafi Abdullah F, Beyari Mohammed B, Alahmadi Raghad A, Almazro Abdulah A

机构信息

Department of General Surgery, Consultant in Colorectal Surgery, Prince Sultan Military Medical City, Riyadh, SAU.

Saudi Board General Surgery Residency Program, King Fahad General Hospital, Jeddah, SAU.

出版信息

Cureus. 2025 Jan 30;17(1):e78247. doi: 10.7759/cureus.78247. eCollection 2025 Jan.

DOI:10.7759/cureus.78247
PMID:39885939
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11781804/
Abstract

Lipoma is a benign tumor that arises from mesenchymal cells and is considered relatively rare. Although lipomas can develop anywhere in the digestive tract, they are seldom found within the intestinal tract. Typically asymptomatic, colonic lipomas usually do not require treatment unless they result in symptoms that warrant surgical intervention. In this case, a 68-year-old male patient presented to the colorectal clinic with complaints of chronic constipation lasting five years, along with a bulging protrusion through the anus that could be reduced by the patient's finger. He reported no history of abdominal pain, change in bowel habits, rectal bleeding, melena, weight loss, fever, or night sweats. During colonoscopy, large subepithelial lesions, measuring greater than 2 cm, were observed proximal to the anal verge. This case report highlights the significance of accurately diagnosing colonic lipomas to prevent potential misdiagnoses as malignancies or rectal prolapses. Additionally, we advocate for treatment strategies tailored to several factors, including the lipoma's size, location, and any associated symptoms.

摘要

脂肪瘤是一种起源于间充质细胞的良性肿瘤,被认为相对罕见。尽管脂肪瘤可在消化道的任何部位发生,但在肠道内很少见。结肠脂肪瘤通常无症状,一般不需要治疗,除非出现需要手术干预的症状。在本病例中,一名68岁男性患者因持续五年的慢性便秘以及可通过手指回纳的经肛门突出肿物就诊于结直肠诊所。他报告无腹痛、排便习惯改变、直肠出血、黑便、体重减轻、发热或盗汗史。在结肠镜检查中,在肛门缘近端观察到大于2 cm的大的上皮下病变。本病例报告强调了准确诊断结肠脂肪瘤以防止潜在的恶性肿瘤或直肠脱垂误诊的重要性。此外,我们主张根据脂肪瘤的大小、位置和任何相关症状等多种因素制定治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c310/11781804/40a6e8806fa5/cureus-0017-00000078247-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c310/11781804/b2d579347b43/cureus-0017-00000078247-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c310/11781804/40a6e8806fa5/cureus-0017-00000078247-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c310/11781804/b2d579347b43/cureus-0017-00000078247-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c310/11781804/40a6e8806fa5/cureus-0017-00000078247-i02.jpg

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本文引用的文献

1
Colonic Lipoma Causing Bowel Intussusception: An Up-to-Date Systematic Review.结肠脂肪瘤致肠套叠:最新系统评价
J Clin Med. 2021 Nov 2;10(21):5149. doi: 10.3390/jcm10215149.
2
Pedunculated colonic lipoma prolapsing through the anus.带蒂结肠脂肪瘤经肛门脱出
World J Clin Cases. 2015 May 16;3(5):457-61. doi: 10.12998/wjcc.v3.i5.457.
3
Giant colonic lipoma with prolapse through the rectum treated by external local excision: A case report.经肛门外局部切除治疗的巨大直肠脱垂型结肠脂肪瘤:病例报告
Oncol Lett. 2014 Sep;8(3):1377-1379. doi: 10.3892/ol.2014.2317. Epub 2014 Jul 4.
4
Resolution of intussusception after spontaneous expulsion of an ileal lipoma per rectum: a case report and literature review.直肠自发性排出回肠脂肪瘤后肠套叠的缓解:一例报告及文献综述
World J Surg Oncol. 2014 May 7;12:143. doi: 10.1186/1477-7819-12-143.
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Rare cause of intestinal obstruction - submucous lipoma of the sigmoid colon.肠梗阻的罕见病因——乙状结肠黏膜下脂肪瘤。
Chirurgia (Bucur). 2014 Jan-Feb;109(1):142-7.
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Pedunculated lipoma causing colo-colonic intussusception: a rare case report.带蒂脂肪瘤致结肠-结肠套叠:一例罕见病例报告
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Am J Case Rep. 2013 Jul 24;14:270-5. doi: 10.12659/AJCR.889247. Print 2013.
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Lipoma of the colon: should asymptomatic tumors be treated?结肠脂肪瘤:无症状肿瘤是否应接受治疗?
Am Surg. 2013 Jan;79(1):E45-6.
9
Transanal resection of rectal lipoma mimicking rectal prolapse: description of a case and review of the literature.经肛门切除酷似直肠脱垂的直肠脂肪瘤:1例病例描述及文献复习
ISRN Surg. 2011;2011:170285. doi: 10.5402/2011/170285. Epub 2011 Apr 10.
10
Autoamputation of a giant colonic lipoma.巨结肠脂肪瘤自动截肢。
Gut Liver. 2011 Sep;5(3):380-2. doi: 10.5009/gnl.2011.5.3.380. Epub 2011 Aug 18.