A Case of Colonic Lipoma Causing Intussusception Treated with Elective Surgery

DOI 1 Citations 42 References
  • Hashimoto Takuzou
    Department of Surgery II, Tokyo Women's Medical University School of Medicine
  • Itabashi Michio
    Department of Surgery II, Tokyo Women's Medical University School of Medicine
  • Soyama Koichi
    Department of Surgery, Omiya Central General Hospital
  • Tani Hideki
    Department of Surgery II, Tokyo Women's Medical University School of Medicine
  • Kanbe Tomomitsu
    Department of Surgery, Omiya Central General Hospital
  • Shibata Noriyuki
    Department of Pathology I, Tokyo Women's Medical University School of Medicine
  • Kobayashi Makio
    Department of Pathology I, Tokyo Women's Medical University School of Medicine
  • Kameoka Shingo
    Department of Surgery, Omiya Central General Hospital

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  • 腸重積を呈した大腸脂肪腫に対して待機的手術を施行した1例

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Abstract

A 71-year-old woman was admitted to the emergency department of our hospital because of melena and abdominal pain. A barium enema demonstrated a tumor measuring about 4 cm in diameter with crab-like onychoid findings in the splenic flexure and computed tomography demonstrated a mass with fat density. The tumor surface was eroded and ulcerated on colonoscopy, and both pillow sign and cushion sign were negative. Intussusception related to lipoma was doubted, but the abdominal findings were not severe. Surgery was therefore indicated and partial resection of the colon was scheduled. The transverse colon was slightly impacted into the descending colon at the left splenic flexure. The mass was diagnosed as a lipoma arising from the submucosal layer. With continuous mechanical stimulation, infl ammatory changes had increased on the tumor surface, and the lipoma did not show typical findings. This makes it important to use other tests together with CT to make a definite diagnosis. Lipoma is a highly elastic tumor, so in some cases, despite the presence of pre-poerative invagination and invaginational release, symptoms may be limited. Therefore we think that surgery should be performed based on close observation of abdominal findings.

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