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Case Reports
, 7 (22), 3765-3771

Ulcerated Intussuscepted Jejunal Lipoma-Uncommon Cause of Obscure Gastrointestinal Bleeding: A Case Report

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Case Reports

Ulcerated Intussuscepted Jejunal Lipoma-Uncommon Cause of Obscure Gastrointestinal Bleeding: A Case Report

Tudor Cuciureanu et al. World J Clin Cases.

Abstract

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 en bloc, 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.

Keywords: Case report; Computed tomography; Gastrointestinal bleeding; Intussusception; Lipoma; Video capsule endoscopy.

Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Videocapsule endoscopy findings obtained from our patient. A: Fresh blood in the jejunum; B: Protruding jejunal lesion.
Figure 2
Figure 2
Images acquired through enteroscopy performed in our patient. A: Ulcerated tumoral mass; B: Tumoral mass with partial bowel obstruction.
Figure 3
Figure 3
Contrast–enhanced abdominal computed tomography scan. Both axial (left) and coronal (right) reformatted images show a large elongated structure inside of intestinal lumen (arrowheads) with homogeneous fat density and smooth, well defined contour.
Figure 4
Figure 4
Macroscopic appearance of the jejunal lipoma (arrow).
Figure 5
Figure 5
Jejunal submucosal lipoma with ulcerated area of the mucosa. A: Full section (Hematoxylin-eosin staining, × 40); B: Detail (Hematoxylin-eosin staining, × 200).

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References

    1. Zirpe D, Wani M, Tiwari P, Ramaswamy PK, Kumar RP. Duodenal Lipomatosis as a Curious Cause of Upper Gastrointestinal Bleed: A Report with Review of Literature. J Clin Diagn Res. 2016;10:PE01–PE04. - PMC - PubMed
    1. Kordzadeh A, Lorenzi B, Elias S, Khan MJK, Charalabopoulos A. Subtle presentation of jejunal lipomata with intussusception in a young adult. J Surg Case Rep. 2017;2017:rjx199. - PMC - PubMed
    1. Uyulmaz S, Zünd M, Caspar U, Diebold J, Slankamenac K. Ileoileal intussusception in unspecific recurrent abdominal pain in adult: A case report. SAGE Open Med Case Rep. 2018;6:2050313X18792814. - PMC - PubMed
    1. Manouras A, Lagoudianakis EE, Dardamanis D, Tsekouras DK, Markogiannakis H, Genetzakis M, Pararas N, Papadima A, Triantafillou C, Katergiannakis V. Lipoma induced jejunojejunal intussusception. World J Gastroenterol. 2007;13:3641–3644. - PMC - PubMed
    1. Onkendi EO, Grotz TE, Murray JA, Donohue JH. Adult intussusception in the last 25 years of modern imaging: is surgery still indicated? J Gastrointest Surg. 2011;15:1699–1705. - PubMed

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