Osman Eman Ibrahim Abdalla, Elsayed Mohammed Latif, Samuel Premila, Amor Khadija Ben, Alshammari Turki Faheem
Department of General Surgery, Hafer Albatin Central Hospital, Hafer Albatin, Saudi Arabia.
Am J Case Rep. 2025 Mar 27;26:e946215. doi: 10.12659/AJCR.946215.
BACKGROUND Ileo-cecal lipomatosis is a rare, benign condition characterized by diffuse submucosal adipose tissue infiltration in the intestinal wall. While usually asymptomatic, it occasionally presents with complications such as bowel obstruction, perforation, or mimicry of acute appendicitis, often leading to diagnostic challenges. CASE REPORT A 29-year-old obese woman presented to the Emergency Department with acute abdominal pain, nausea, vomiting, and fever, clinically suggestive of acute appendicitis. Examination revealed right iliac fossa tenderness, and laboratory findings showed elevated white blood cell counts. Computed tomography (CT) imaging indicated an inflammatory mass in the ileo-cecal region, raising suspicion for appendicitis with possible abscess formation. During emergency laparotomy, diffuse thickening and lipomatous infiltration of the ileo-cecal junction were identified rather than a ruptured appendix. Ileo-cecal resection was performed, and histopathological analysis confirmed diffuse submucosal lipomatosis without malignancy or evidence of true inflammatory appendicitis. CONCLUSIONS This case emphasizes the importance of considering rare conditions like intestinal lipomatosis in the differential diagnosis of acute abdominal pain, particularly in atypical presentations. While radiological findings may suggest common conditions like appendicitis, they may be inconclusive, necessitating surgical exploration. Early recognition of ileo-cecal lipomatosis is essential for timely and appropriate management, reducing the risk of unnecessary procedures or complications. Increasing awareness of this rare entity among clinicians can improve diagnostic accuracy and patient outcomes.
背景 回盲部脂肪瘤病是一种罕见的良性疾病，其特征为肠壁内弥漫性黏膜下脂肪组织浸润。虽然通常无症状，但偶尔会出现肠梗阻、穿孔或类似急性阑尾炎等并发症，常导致诊断困难。病例报告 一名29岁肥胖女性因急性腹痛、恶心、呕吐和发热就诊于急诊科，临床提示急性阑尾炎。检查发现右下腹压痛，实验室检查结果显示白细胞计数升高。计算机断层扫描（CT）成像显示回盲部有炎性肿块，怀疑为阑尾炎并可能形成脓肿。在急诊剖腹手术中，发现回盲部弥漫性增厚和脂肪瘤样浸润，而非阑尾破裂。进行了回盲部切除术，组织病理学分析证实为弥漫性黏膜下脂肪瘤病，无恶性病变或真正炎性阑尾炎的证据。结论 本病例强调了在急性腹痛的鉴别诊断中考虑肠道脂肪瘤病等罕见疾病的重要性，尤其是在非典型表现时。虽然影像学检查结果可能提示阑尾炎等常见疾病，但可能不明确，需要进行手术探查。早期识别回盲部脂肪瘤病对于及时、恰当的治疗至关重要，可降低不必要的手术或并发症风险。提高临床医生对这种罕见疾病的认识有助于提高诊断准确性和患者预后。
