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Ulcerated intussuscepted jejunal lipoma-uncommon cause of obscure gastrointestinal bleeding: A case report

查看全文 作　　者：Tudor [1]Cuciureanu;Laura [1]Huiban;Stefan [1]Chiriac;Ana-Maria [1]Singeap;Mihai [2]Danciu;Florin [3]Mihai;Carol [1]Stanciu;Anca [1]Trifan;Nutu [4]Vlad 高影响力作者 机构地区：[1]Department of Gastroenterology,“Grigore T.Popa”University of Medicine and Pharmacy,“St.Spiridon”Emergency Hospital,Iasi 700115,Romania;[2]Department of Pathology,“Grigore T.Popa”University of Medicine and Pharmacy,“St.Spiridon”Emergency Hospital,Iasi 700115,Romania;[3]Department of Radiology,“Grigore T.Popa”University of Medicine and Pharmacy,“St.Spiridon”Emergency Hospital,Iasi 700115,Romania;[4]Department of General Surgery,“Grigore T.Popa”University of Medicine and Pharmacy,“St.Spiridon”Emergency Hospital,Iasi 700115,Romania高影响力机构 出　　处：《World Journal of Clinical Cases》索引2019年第7卷第22期,共7页高影响力期刊 摘　　要：BACKGROUND Intestinal lipomas are rare benign gastrointestinal(GI)tumors,usually asymptomatic,but may become symptomatic as the result of some complications such as intussusception,intestinal obstruction,volvulus or bleeding.They can occur at any site along the entire GI tract,more frequent in colon and rarely in small intestine.The patient reported here is a very rare case of jejunal lipoma,ulcerated and intussuscepted,diagnosed in an adult investigated for a chronic iron deficiency anemia(IDA),and successfully managed by segmental jejunal resection.CASE SUMMARY A 63-year-old male was referred to“St.Spiridon”Hospital,Institute of Gastroenterology and Hepatology,Iasi,to investigate an obscure GI bleeding with an IDA.After upper GI endoscopy and colonoscopy were performed,excluding potentially bleeding lesions,videocapsule endoscopy was then carried out,revealing fresh blood and a protruding lesion in proximal jejunum,findings confirmed by a single-balloon enteroscopy.Multiple biopsies were taken from the lesion,but histological results were inconclusive.Then,contrast-enhanced computed tomography was performed showing jejunal polypoid mass with homogenous fat density,suggestive for lipoma.A week later a laparotomy was performed revealing the intussuscepted jejunal segment which was resected enbloc,and sent for further histopathologic analysis.The patient made an uneventful recovery and was discharged seven days later,and at six months follow-up he had no complains and his hemoglobin returned to normal value.CONCLUSION Lipomas are very rarely located in the jejunum,usually asymptomatic,but they may lead to complications such as intussusception and bleeding.Surgical resection remains the treatment of choice. 关 键 词：LIPOMA INTUSSUSCEPTION COMPUTED tomography Video capsule endoscopy Gastrointestinal BLEEDING Case report
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