Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Apr 7, 2010; 16(13): 1676-1679
Published online Apr 7, 2010. doi: 10.3748/wjg.v16.i13.1676
Peeling a giant ileal lipoma with endoscopic unroofing and submucosal dissection
Takashi Morimoto, Kuang-I Fu, Hironori Konuma, Yuko Izumi, Syujirou Matsuyama, Kanako Ogura, Akihisa Miyazaki, Sumio Watanabe
Takashi Morimoto, Kuang-I Fu, Hironori Konuma, Yuko Izumi, Syujirou Matsuyama, Akihisa Miyazaki, Department of Gastroenterology, Juntendo University Nerima Hospital, Tokyo 177-8521, Japan
Kanako Ogura, Department of Pathology, Juntendo University Nerima Hospital, Tokyo 177-8521, Japan
Sumio Watanabe, Department of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
Author contributions: Morimoto T and Fu KI supplemented the data about the patient; Konuma H, Izumi Y, Matsuyama S, Ogura K, Miyazaki A and Watanabe S analyzed the data about the patient; Morimoto T and Fu KI wrote the paper.
Correspondence to: Kuang-I Fu, MD, PhD, Department of Gastroenterology, Juntendo University Nerima Hospital, 3-1-10 Nerimatakanodai, Nerima, Tokyo 177-8521, Japan. fukuangi@hotmail.com
Telephone: +81-3-59233111 Fax: +81-3-59233111
Received: December 5, 2009
Revised: January 1, 2010
Accepted: January 8, 2010
Published online: April 7, 2010
Abstract

Lipoma is relatively common in the colon but is less often in the small intestine. Most lipomas are incidentally detected at endoscopy and are usually small and asymptomatic. However, some of them can present with obstruction and/or intussusceptions. Surgical resection is commonly recommended to remove such significant lipomas with a limited pedicle and larger than 2 cm in size, as endoscopic resection may result in unfavorable complications such as intestinal perforations. We report a case of 62-year-old man presenting with hematochezia. Colonoscopy showed a submucosal tumor, about 50 mm in size, in the terminal ileum. A clinical diagnosis of lipoma was established based on the findings of colonoscopy and abdominal computed tomography (CT). As the patient complained of hematochezia and mild iron deficiency anemia associated with repeated tumor prolapse, we decided to remove his lipoma. Consequently, the lesion was completely removed en bloc. Although abdominal CT immediately after removal of the lesion showed a small amount of free air, conservative treatment was successfully carried out for the perforation. Histologically, the removed lesion was a lipoma.

Keywords: Lipoma; Endoscopic submucosal dissection; Endoscopic unroofing; Perforation