title: Duodenal Lipomatosis as a Curious Cause of Upper Gastrointestinal Bleed: A Report with Review of Literature.
abstract: Lipomas of the gastrointestinal tract are rare. Duodenal lipomas are incidental and mostly asymptomatic. Tumours may produce symptoms of abdominal pain and discomfort or cause bleeding due to ulceration or intestinal obstruction due to intussusception. We describe a 45-year-old man presenting in emergency with 3 days history of melena with normal gastroduodenoscopy and contrast enhanced computed tomography revealing multiple polypoid lesion in duodenum and proximal jejunum suggestive of lipoma. Due to ongoing bleed, he underwent laparotomy with duodenectomy and uneventful postoperative recovery. Our review of cases published in last 67 years indicate that duodenal lipomas are rare to occur but commonly found in second part, they may be seen in third and fourth part of duodenum which may be missed on endoscopy. They can be multiple and may present as severe UGI bleeding which could be managed surgically. Though CT is diagnostic, histopathology confirms the diagnosis which shows lipomatous lesion composed of mature adipose arranged in lobules.
authors.affiliation: Senior Registrar, Department of Surgical Gastroenterology and Minimal Access Surgery, Apollo Hospitals (Main) , Greams Road, Chennai, Tamilnadu, India .
authors.forename: Dinesh
authors.initials: D
authors.lastname: Zirpe
authors.affiliation: Senior Registrar, Department of Surgical Gastroenterology and Minimal Access Surgery, Apollo Hospitals (Main) , Greams Road, Chennai, Tamilnadu, India .
authors.forename: Majid
authors.initials: M
authors.lastname: Wani
authors.affiliation: Senior Registrar, Department of Surgical Gastroenterology and Minimal Access Surgery, Apollo Hospitals (Main) , Greams Road, Chennai, Tamilnadu, India .
authors.forename: Priyanka
authors.initials: P
authors.lastname: Tiwari
authors.affiliation: Senior Consultant, Department of Medical Gastroenterology, Apollo Hospitals (Main) , Greams Road, Chennai, Tamilnadu, India .
authors.forename: Palaniswamy Kalipatti
authors.initials: PK
authors.lastname: Ramaswamy
authors.affiliation: Senior Consultant, Department of Surgical Gastroenterology and Minimal Access Surgery, Apollo Hospitals (Main) , Greams Road, Chennai, Tamilnadu, India .
authors.forename: Reddy Prasanna
authors.initials: RP
authors.lastname: Kumar
keywords: Bleeding; Duodenectomy; Lipoma; Melena