Laparoscopic extraction of a symptomatic upper abdominal pedunculated parietal peritoneal lipoma arising intermittent abdominal pain: a case report

J Med Case Rep. 2024 Apr 22;18(1):200. doi: 10.1186/s13256-024-04511-5.

Abstract

Introduction: Lipomas arising in the parietal peritoneum are rare, and some of them cause abdominal pain due to torsion of the pedunculated peritoneum. We encountered a case of parietal peritoneal lipoma arising upper peritoneum. In this report, we describe the detail of clinical presentation and discuss its potential pathogenesis and treatment strategy.

Case presentation: 45 year-old Japanese female patient presented with long-lasting intermittent pain in the left upper abdominal region. Abdominal imaging showed a well-defined fatty mass measuring 40 mm in size, suggesting a parietal peritoneal lipoma. Laparoscopy revealed a tumor with a twisted peduncle; however, no adhesion of the surrounding tissues and ischemic changes were visible. The tumor was easily removed by dissection of the tumor pedicle.

Conclusion: Parietal peritoneal lipoma often shows pedunculated form and it causes abdominal pain by the torsion of tumor pedicle. Therefore, this type of lipoma should be considered a more aggressive surgery.

Keywords: Abdominal wall; Lipoma; Peritoneum.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain* / etiology
  • Female
  • Humans
  • Laparoscopy*
  • Lipoma* / complications
  • Lipoma* / diagnostic imaging
  • Lipoma* / surgery
  • Middle Aged
  • Peritoneal Neoplasms* / complications
  • Peritoneal Neoplasms* / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome