[Lipoma of the small intestine as a rare cause of intestinal occlusion].
Lipoma is a benign tumour of mesenchymal origin which is not frequently localized in the gastroenteric tract; in anatomopathological statistics it is less rare: this is due to the fact that it rarely reaches dimensions which warrant surgical treatment. It is usually either an occasional finding during the course of laparotomy due to other motives or is the cause of complications, as in the present case of intestinal occlusion due to ileocolic invagination, resulting in emergency surgery. As a cause of occlusion tumours of the small bowel are second in terms of incidence to adhesive factors, volvuli and hernias. Invaginations account for 2/3 of small bowel occlusions caused by up to 80% of tumours: the lipoma is the most frequent benign tumour to cause invagination in its submucous polypoid and more or less scissile form. Symptoms are not specific and this causes a delay in diagnosis. Patients are often young subjects with a history of recurrent abdominal colic and sensitivity to anti-spastic drugs so much so that in the past they were diagnosed as "chronic colic" sufferers. Sometimes the only symptom is dyspepsia, or nausea and vomiting, or occasionally abdominal distension with constipation or attacks of diarrhoea. Radiology is not of great value in the diagnosis except for indicating the possible need for emergency surgery. There are no radiological tests, with or without contrast mediums, echography, CAT or MNR which can diagnose this pathology. The decision to operate is usually triggered by the presence of a complication, but perioperative extemporary histological tests are advisable for a correct surgical approach: if the form is scissile, segmentary resection of the small bowel is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
Nincheri Kunz
M
M
Divisione di Chirurgia Generale, Ospedale Sant'Andrea, La Spezia.
Evaristi
L
L
Spadoni
R
R
Cozzani
R
R
Valle
O
O
Bacigalupo
B
B
D006801:Humans; D007077:Ileal Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D007078:Ileal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D007082:Ileum / Q000473:pathology; D007415:Intestinal Obstruction / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D007902:Length of Stay; D008067:Lipoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013997:Time Factors
Lipoma del tenue come rara causa di occlusione intestinale.