title: Peeling a giant ileal lipoma with endoscopic unroofing and submucosal dissection.
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.
authors.affiliation: Department of Gastroenterology, Juntendo University Nerima Hospital, Tokyo 177-8521, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Kuang-I
authors.initials: KI
authors.lastname: Fu
authors.forename: Hironori
authors.initials: H
authors.lastname: Konuma
authors.forename: Yuko
authors.initials: Y
authors.lastname: Izumi
authors.forename: Syujirou
authors.initials: S
authors.lastname: Matsuyama
authors.forename: Kanako
authors.initials: K
authors.lastname: Ogura
authors.forename: Akihisa
authors.initials: A
authors.lastname: Miyazaki
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D003113:Colonoscopy / Q000379:methods; D013505:Digestive System Surgical Procedures; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007413:Intestinal Mucosa / Q000473:pathology; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008067:Lipoma / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome