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小儿肠系膜脂肪瘤致小肠梗阻:罕见的中肠扭转病例

Mesenteric Lipoma-Induced Small Bowel Obstruction in a Pediatric Patient: A Rare Case of Midgut Volvulus.

作者信息

Guzman Rafael A, Wallace Bryan A, Othman Feras, Lake Charissa, Calisto Juan

机构信息

General Surgery, St. George's University School of Medicine, True Blue, GRD.

General Surgery, University of Miami, Coral Gables, USA.

出版信息

Cureus. 2025 Mar 4;17(3):e80058. doi: 10.7759/cureus.80058. eCollection 2025 Mar.

Abstract

Mesenteric lipomas are rare benign tumors composed of adipocytes, representing a small subset of intestinal lipomas. Although typically asymptomatic, large lipomas can cause significant complications, such as small bowel obstruction (SBO), particularly when they induce bowel volvulus. We present a case of a 10-year-old female with no notable past medical history who developed SBO due to a mesenteric lipoma causing volvulus. This case highlights a rare condition with a unique clinical presentation that is not commonly seen in the literature. Imaging studies, including ultrasound, abdominal X-ray, and contrast-enhanced CT, identified a fat-dense mass in the right lower quadrant (RLQ) that led to small bowel rotation and obstruction. Surgical resection confirmed the diagnosis of mesenteric lipoma. This case emphasizes how significant complications can develop, even in the setting of benign tumors. Given the potential for serious complications, such as midgut volvulus and SBO, further research into the clinical presentation, diagnostic strategies, and management of mesenteric lipomas in pediatric populations is essential to improve patient outcomes and guide future clinical practice.

摘要

肠系膜脂肪瘤是由脂肪细胞构成的罕见良性肿瘤,是肠道脂肪瘤中的一小部分。虽然通常无症状,但大的脂肪瘤可引起严重并发症,如小肠梗阻(SBO),尤其是当它们导致肠扭转时。我们报告一例10岁女性病例,既往无显著病史,因肠系膜脂肪瘤导致肠扭转而发生SBO。该病例突出了一种罕见疾病,其具有独特的临床表现,在文献中并不常见。包括超声、腹部X线和增强CT在内的影像学检查发现右下腹(RLQ)有一个脂肪密度肿块,导致小肠扭转和梗阻。手术切除证实为肠系膜脂肪瘤。该病例强调了即使是良性肿瘤也可能发生严重并发症。鉴于存在中肠扭转和SBO等严重并发症的可能性,进一步研究儿科人群中肠系膜脂肪瘤的临床表现、诊断策略和管理对于改善患者预后和指导未来临床实践至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b6a/11968451/063124104408/cureus-0017-00000080058-i01.jpg

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