Endoscopic submucosal dissection and submucosal tunneling endoscopic resection for obstructive lipomas of the foregut and hindgut

摘要

GI lipomas are rare, benign, submucosal tumorsthat are usually asymptomatic. The most common loca-tion for these lesions is the colon (64%), whereasduodenal lipomas account for only 4% of GI lipomas. 1Large lipomas (>2-4 cm) may cause symptomssuch as bleeding, abdominal pain, obstruction, orintussusception. 1-16 They typically present as a smooth,slightly yellow, rounded polyp, with a stalk or a broad-based attachment. Diagnosis can be confirmed by EUS,CT scan, or magnetic resonance imaging. There is nostandardized treatment for symptomatic lipomas, andboth surgical 16 and endoscopic approaches have beendescribed, 1-15 depending on the size and location ofthe lesion and on the availability of advanced endoscopictechniques.