Resolution of intussusception after spontaneous expulsion of an ileal lipoma per rectum: a case report and literature re
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Resolution of intussusception after spontaneous expulsion of an ileal lipoma per rectum: a case report and literature review Bin Kang1, Qingkai Zhang1, Dong Shang1*, Qingqiang Ni1, Faheem Muhammad1, Li Hou2 and Wenjun Cui3
Abstract We herein report a case of spontaneous rectal expulsion of an ileal lipoma in a 65-year-old female patient who presented with recurrent attacks of subacute intestinal obstruction. During each episode, the patient developed severe abdominal pain and expelled a fleshy mass from her rectum. The fleshy mass was histopathologically diagnosed as a lipoma comprising fat cells, fibers, and blood vessels. Upon expulsion, the pain disappeared and the intussusception was immediately resolved. Colonoscopic examination revealed a 2.5-cm diameter ulcerated lesion near the ileocecal valve, which was confirmed to be inflammation by pathological examination. A subsequent barium series revealed a normal colonic tract, and the patient remained completely symptom-free for 4 months after the incident. According to the relevant literature and our clinical experience, the treatment method for a lipoma depends on the patient’s clinical manifestations and the size of the tumor. However, the various diagnostic and therapeutic modalities currently available continue to be debated; whether an asymptomatic lipoma requires treatment is controversial. When histopathological examination results allow for the exclusion of malignant lesions such as sarcoma, a lipoma can be resected surgically. Keywords: Expulse, Intussusception, Lipoma, Self-healing, Small intestine
Background Small intestinal tumors are extremely rare, accounting for only 1% to 2% of gastrointestinal tumors worldwide [1], and only around 30% of small intestinal tumors are benign. Lipoma, which is less prevalent than leiomyoma and adenoma, is the third most common primary benign tumor in the gut [2]. Small bowel tumors are rare entities that often present with nonspecific symptoms. When these tumors are >2 cm in diameter, abdominal pain, hematochezia, and/or incomplete intestinal obstruction may appear. The lack of specific clinical manifestations makes it difficult to reach a definite preoperative diagnosis; sometimes the lipoma is even ignored after the development of an intussusception. Moreover, it is difficult to identify symptomatic patients with malignant tumors, which can consequently be misdiagnosed. Most intestinal lipomas * Correspondence: [email protected] 1 Department of Acute Abdominal Surgery, First Affiliated Hospital, Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, Liaoning Province, China Full list of author information is available at the end of the article
are located in the distal ileum and colorectal region (mainly the right colon) and are rarely located in the stomach or proximal small intestine. Intestinal lipomas seldom deteriorate, and they do not relapse after cure. Intussusception was reported for the first time in 1674 by Barbette of Amsterdam [
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