Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3765
Peer-review started: September 18, 2019
First decision: October 24, 2019
Revised: October 29, 2019
Accepted: November 15, 2019
Article in press: November 15, 2019
Published online: November 26, 2019
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.
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.
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.
Core tip: Jejunal lipomas are very rare benign tumors in adults, usually asymptomatic, and found incidentally during investigation for other abdominal pathologies or when cases present a complication such as intussusception, intestinal obstruction or bleeding. Here we present a case of jejunal lipoma complicated by ulceration, intussusception, and gastrointestinal bleeding, successfully managed by segmental resection. Location of lipoma in jejunum is exceptional with only 10 cases reported in the literature with similar location and complications as our case.