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Novel surgical approach without bowel resection for multiple gastrointestinal lipomatosis: A case report

机译:无需肠切除的新型手术方法治疗多发性胃肠道脂肪瘤病1例

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Introduction Asymptomatic lipoma only requires observation, whereas symptomatic lipoma requires treatment such as endoscopic or surgical resection. However, in case of multiple lipomas, with evident diffusion and malignancy, resection procedure and range cannot be determined. We experienced GI lipomatosis (multiple lipomas) diffusely existing from the duodenum to the small intestine and involved recurrent intussusception. Presentation of case 47 year-old female was a history of open bowel resection for intestinal obstruction caused by intussusceptions of multiple small intestinal lipoma 11 years ago. EGD showed duodenal lipoma, and CT showed diffuse multiple lipomas from the proximal jejunum to the distal ileum. Another CT also showed intussusception of small intestine, but no signs of intestinal obstruction. Surgical procedures performed included diagnostic laparoscopy. All intestinal lipomas were resected with local excision, and duodenal lipoma was resected with ESD without any bowel resection. Discussion Multiple local excision??ESD for multiple GI lipomatosis have not been reported. The most problematic thing is that if extensive resection is performed to cut off all multiple lipoma, short bowel syndrome may occur. Determining the range to be cut remains unclear. Conclusions Multiple local excision?±?ESD seemed to be one of the methods in resecting multiple GI lipomatosis. In the future, cases and indications of surgery and resection method for GI lipoma should be accumulated and considered, respectively.
机译:简介无症状性脂肪瘤仅需观察,而症状性脂肪瘤则需要内窥镜或手术切除等治疗。但是,如果有多个脂肪瘤,且有明显的扩散和恶性肿瘤,则无法确定切除程序和范围。我们经历了从十二指肠到小肠广泛存在的胃肠道脂肪瘤(多发性脂肪瘤),并累及了反复的肠套叠。该病例为47岁女性,是11年前因肠小肠多发性肠套叠引起的肠梗阻而进行开放式肠切除术的历史。 EGD显示十二指肠脂肪瘤,CT显示从空肠近端至回肠远端弥漫性多个脂肪瘤。另一CT也显示肠套叠小肠,但没有肠梗阻的迹象。进行的外科手术包括诊断性腹腔镜检查。所有肠脂瘤均经局部切除术切除,十二指肠脂肪瘤经ESD切除而无肠切除。讨论尚未有关于多发性胃肠道脂肪瘤病的多发局部切除术ESD报道。最有问题的是,如果进行大范围切除以切除所有多发性脂肪瘤,可能会发生短肠综合征。确定切割范围尚不清楚。结论多次局部切除±ESD似乎是切除多发性胃肠炎的方法之一。将来,应进一步考虑消化道脂肪瘤的手术情况和适应症以及切除方法。

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