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Small bowel volvulus due to a large intestinal lipoma: A rare case report

INTRODUCTION: A lipoma of the small bowel mesentery is a uncommon clinical entity. It rarely causes obstruction and volvulus of the small bowel. CASE REPORT: A 63 year old man was admitted to the emergency department with acute abdominal pain. Contrast-enhanced CT abdominal scan revealed small bowel...

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Autores principales: Buono, Giuseppe Di, Ricupati, Federica, Amato, Giuseppe, Gulotta, Leonardo, Romano, Giorgio, Agrusa, Antonino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876929/
https://www.ncbi.nlm.nih.gov/pubmed/33041254
http://dx.doi.org/10.1016/j.ijscr.2020.09.123
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author Buono, Giuseppe Di
Ricupati, Federica
Amato, Giuseppe
Gulotta, Leonardo
Romano, Giorgio
Agrusa, Antonino
author_facet Buono, Giuseppe Di
Ricupati, Federica
Amato, Giuseppe
Gulotta, Leonardo
Romano, Giorgio
Agrusa, Antonino
author_sort Buono, Giuseppe Di
collection PubMed
description INTRODUCTION: A lipoma of the small bowel mesentery is a uncommon clinical entity. It rarely causes obstruction and volvulus of the small bowel. CASE REPORT: A 63 year old man was admitted to the emergency department with acute abdominal pain. Contrast-enhanced CT abdominal scan revealed small bowel obstruction due to a large fat density lesion suspected to be a lipoma. We performed a laparotomy in urgent setting that confirmed a small bowel volvulus secondary to a large antimesenteric lipoma. En-bloc resection with antiperistaltic side-to-side ileal anastomosis was done. DISCUSSION: Mesenteric lipoma is rare. They are usually asymptomatic but when have large sizes can cause several symptoms related to small bowel obstruction or volvulus. The diagnosis is difficult and is rarely made prior to exploratory laparoscopy or laparotomy. CT scan is the gold-standard imaging technique. It can shows the typical characteristics of tumor and may demonstrate the typical “vortex” pattern of a volvulus. In patients with acute clinical presentation en-bloc resection of the lipoma with the affected small bowel loops is often necessary. This treatment may also be reserved in asymptomatic patients with large mesenteric lipomas to avoid future complications. CONCLUSION: Volvulus of the small bowel caused by an antimesenteric lipoma is a very rare entity. It is diagnosed by CT scan and surgery represents the standard treatment.
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spelling pubmed-78769292021-02-18 Small bowel volvulus due to a large intestinal lipoma: A rare case report Buono, Giuseppe Di Ricupati, Federica Amato, Giuseppe Gulotta, Leonardo Romano, Giorgio Agrusa, Antonino Int J Surg Case Rep Case Report INTRODUCTION: A lipoma of the small bowel mesentery is a uncommon clinical entity. It rarely causes obstruction and volvulus of the small bowel. CASE REPORT: A 63 year old man was admitted to the emergency department with acute abdominal pain. Contrast-enhanced CT abdominal scan revealed small bowel obstruction due to a large fat density lesion suspected to be a lipoma. We performed a laparotomy in urgent setting that confirmed a small bowel volvulus secondary to a large antimesenteric lipoma. En-bloc resection with antiperistaltic side-to-side ileal anastomosis was done. DISCUSSION: Mesenteric lipoma is rare. They are usually asymptomatic but when have large sizes can cause several symptoms related to small bowel obstruction or volvulus. The diagnosis is difficult and is rarely made prior to exploratory laparoscopy or laparotomy. CT scan is the gold-standard imaging technique. It can shows the typical characteristics of tumor and may demonstrate the typical “vortex” pattern of a volvulus. In patients with acute clinical presentation en-bloc resection of the lipoma with the affected small bowel loops is often necessary. This treatment may also be reserved in asymptomatic patients with large mesenteric lipomas to avoid future complications. CONCLUSION: Volvulus of the small bowel caused by an antimesenteric lipoma is a very rare entity. It is diagnosed by CT scan and surgery represents the standard treatment. Elsevier 2020-09-25 /pmc/articles/PMC7876929/ /pubmed/33041254 http://dx.doi.org/10.1016/j.ijscr.2020.09.123 Text en © 2020 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Buono, Giuseppe Di
Ricupati, Federica
Amato, Giuseppe
Gulotta, Leonardo
Romano, Giorgio
Agrusa, Antonino
Small bowel volvulus due to a large intestinal lipoma: A rare case report
title Small bowel volvulus due to a large intestinal lipoma: A rare case report
title_full Small bowel volvulus due to a large intestinal lipoma: A rare case report
title_fullStr Small bowel volvulus due to a large intestinal lipoma: A rare case report
title_full_unstemmed Small bowel volvulus due to a large intestinal lipoma: A rare case report
title_short Small bowel volvulus due to a large intestinal lipoma: A rare case report
title_sort small bowel volvulus due to a large intestinal lipoma: a rare case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876929/
https://www.ncbi.nlm.nih.gov/pubmed/33041254
http://dx.doi.org/10.1016/j.ijscr.2020.09.123
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