Diagnosis and treatment of intestinal lipoma / 中国普通外科杂志

ABSTRACT

Objective To analyze the main clinical manifestations of intestinal lipoma and discuss the treatment of intestinal lipoma.Methods The clinical data of 19 patients with intestinal lipoma treated in our hospital in recent 15 years were analyzed retrospectively.CT,ultrasonography,and colonoscopy were used in diagnosis.Local intestinal resection by laparoscopy and laparotomy were employde.Results Intestinal lipoma presented with a variety of symptoms including intestinal bleeding,abdominal pain,anemia,intussusception,and bowel obstruction.In 17 of the intestinal lipoma patients,the main clinical manifestations were change of bowel habits,abdominal pain and bloody stool;13 of them had intestinal intussusception or obstruction,and two patients were asymptomatic.Sixteen patients underwent colonoscopy,and seven of them were correctly diagnosed.Seventeen patients received surgical resection and recovered.The diameter of mass was 3-6.5 cm.The pathologic exam showed submucosal lipoma in 12 cases,two cases showed ulcer formation with erosion,2 cases had intermural lipoma and one case had atypical lipoma with potential malignant transformation.Two asymptomatic patients diagnosed by colonoscopic biopsy werre only followed up at regular intervals.Conclusions Imaging diagnosis and colonoscopy are helpful in the preoperative diagnosis of intestinal lipoma.The method of treatment is based on the size of the tumor and presence or absence of pedicle.Endoscopic electrosection is often used for tumor mass less than 3 cm in diameter,otherwise local intestinal resection is the treatment of chocie.