A research team from China reported a case of 68-year-old man complaining of abdominal bloating for 10 d due to multiple lipomas arising from jejunal duplication cysts. This case highlights intestinal lipoma as an uncommon cause of adult intussusceptions, which should be included in the differential diagnosis of small intestinal obstruction and appropriate examinations should be chosen.
Lipoma of the small intestine is a benign tumor of mesenchymal origin which is mostly found by chance during gastrointestinal investigation. Invaginations account for 2/3 of small bowel occlusion caused by up to 80% of tumors and the lipoma is the most frequent benign tumor that causes invagination in its submucous polypoid and it is in more or less scissile form. However, multiple lipomas within the intestinal duplication canal as a predominant cause of partial intestinal obstruction is an exceptional clinical scenario.
A research article to be published on May 7, 2010 in the World Journal of Gastroenterology addresses this question. The research team from Department of Gastroenterology, Renmin Hospital of Wuhan University, reported a case of a 68-year-old man with a 10-d history of abdominal bloating after meals caused by intussusception due to a small intestine lipomatous lesion located in the jejunal duplication cyst.
Multiple lipomas within jejunal duplication cysts are rare and difficult to diagnose before surgery. This case highlights small intestinal lipoma, though uncommon, should be included in the differential diagnosis of intestinal obstruction and appropriate examination methods should be chosen. Such a case found by double-balloon endoscopy is an example to remind doctors to be vigilant in diagnosing patients with intestinal obstruction and in choosing appropriate examinations.
Wan XY, Deng T, Luo HS. Partial intestinal obstruction secondary to multiple lipomas within jejunal duplication cyst: A case report. World J Gastroenterol 2010; 16(17): 2190-2192. www.wjgnet.com/1007-9327/full/v16/i17/2190.htm