结肠脂肪瘤

本文报告了北京协和医院自1950年至1988年收治的5例结肠脂肪瘤,占同期手术的良性结肠肿瘤182例的2.7％.结肠脂肪瘤在我国罕见,症状隐匿,术前诊断困难。本文对其临床表现及诊断方法进行了讨论.     

结肠脂肪瘤12例诊治分析

结肠脂肪瘤１２例诊治分析凌跃新，黄德骧本文报道中山医院外科１９６７年２月至１９９３年１１月收治１２例结肠脂肪瘤。本病术前诊断困难，其原因除临床表现缺乏特异性外，主要是辅助检查的诊断率不高。本病治疗是行肠局部或部分切除术，有蒂的脂肪瘤可经纤维结肠镜切除...     

结肠脂肪瘤6例

目的:探讨结肠脂肪瘤的临床特点及误诊原因,以提高诊断率.方法:调阅病历、结肠镜、腹部CT、结肠钡剂造影图像、结肠镜活检病理切片、手术切除标本病例切片等资料.对我院1995-2010年病理确诊的6例结肠脂肪瘤病例的临床、内镜下、影像学表现、病理图片及误诊原因进行回顾性分析.结果:3例行结肠钡剂造影,见结肠充盈缺损,诊断结肠癌;1例行腹部CT检查,诊断结肠息肉;6例均行结肠镜检查,均发现结肠黏膜下肿块;诊断结肠癌3例、结肠息肉2例、结肠脂肪瘤1例.6例患者中,仅1例术前获确诊.误诊率83.3%(5/6).误诊原因主要有:该病发病少,临床少见;临床表现无特异性;瘤体表面因炎症、糜烂等,失去内镜下典型表现而酷似结肠癌;医生对本病认识不足.结论:内镜检查时结肠脂肪瘤瘤体同一部位多次深挖活检应可做出正确诊断.治疗可根据情况行内镜下高频电切除或行手术作肠段切除术.     

结肠脂肪瘤

在结肠良性肿瘤中,脂肪瘤的发病仅次于息肉和腺瘤而居于第三位,由于临床症状无特异性,大肠镜检外观与结肠息肉、结肠腺瘤等疾病难以鉴别,并常因内镜活检取材深度达不到而确诊较为困难。现将我院近年来确诊的３例结肠脂肪瘤报告如下。临床资料：１９９１年２月至１９９７年２月经手术及大肠镜下电切除瘤体标本病理证实结肠脂肪瘤３例,资料见表１。例１肠镜下电切除治疗,例２因瘤体较大镜下电切困难行开腹手术切除治疗,例３因腹部包块行剖腹探查切除升结肠浆膜下肿块。此３例术前均未明确诊断结肠脂肪瘤。讨论　１．病理特征：结肠脂肪…     

肠道脂肪瘤的诊断和治疗

背景：肠道脂肪瘤是一种较为少见的肠道良性肿瘤，其临床表现缺乏特异性，难以在术前明确诊断。目的：分析肠道脂肪瘤的主要临床表现和诊治方法，以提高其诊断和治疗的准确性。方法：回顾分析我院1993年1月～2003年1月收治的7例肠道脂肪瘤患者的临床表现及其诊断和治疗经过。结果：除1例患者无症状外。其余6例肠道脂肪瘤患者均以腹痛和(或)便血为主要临床表现。6例行结肠镜等辅助检查者中。仅1例明确诊断。6例患者行外科手术治疗，术后均痊愈，术后病理检查显示4例为黏膜下脂肪瘤，2例为肌壁间脂肪瘤。1例经结肠镜活检明确诊断者因无症状而定期随访。结论：影像学检查和结肠镜检查有助于肠道脂肪瘤的术前诊断，可根据肿瘤大小、有蒂或无蒂选择行经内镜电切术或局部肠段切除术。     

肠脂肪瘤31例诊治分析

目的总结肠脂肪瘤的临床及内镜特点,探讨其诊断及治疗方法。方法回顾性分析31例结直肠及小肠脂肪瘤患者的临床资料,内镜特点、组织病理学及治疗情况。结果肠脂肪瘤表现无特异性,诊断依据结肠镜、超声内镜及病理,31例患者病理均证实为脂肪瘤,28例为结直肠脂肪瘤,5例患者进行了结肠镜下切除,其中2例行黏膜切除术(EMR),1例行黏膜剥离术(ESD),2例行尼龙绳结扎术。3例为小肠脂肪瘤,行剖腹手术确诊。结论肠脂肪瘤易误诊,小肠脂肪瘤可以造成肠梗阻及肠套叠,结肠镜及超声内镜在结直肠脂肪瘤有特征性表现,在诊断及鉴别方面作用明显,需与结肠癌、类癌、平滑肌瘤、气囊肿等鉴别,内镜下微创切除术(EMR、ESD)是治疗结直肠脂肪瘤安全有效的方法,是今后发展的趋势。     

经内镜高频电凝切除结肠脂肪瘤46例疗效观察

结肠脂肪瘤是一种少见的非上皮性良性结肠肿瘤，以往对本病认识不足，常造成诊疗困难。2001年4月-2008年10月，我院诊治结肠脂肪瘤46例。现报告如下。     

肠脂肪瘤致肠套叠二例

肠脂肪瘤引起的肠套叠较为罕见,其临床症状无特异性,易发生漏诊和误诊。CT及内镜检查可协助诊断,确诊依赖病理学检查。手术切除病变肠管是肠脂肪瘤继发肠套叠的一种有效治疗方法。南京医科大学第二附属医院收治了2例肠脂肪瘤继发肠套叠患者,患者均行手术治疗,疗效良好。现对肠脂肪瘤致肠套叠患者的临床表现、诊断及治疗进行讨论,以提高临床医师对此病的认识。     

胃脂肪瘤的诊断与治疗66例

目的: 探讨胃脂肪瘤的流行病学、诊断、治疗及误诊情况, 为临床医生提供借鉴.方法: 2003-2008年辽宁医学院附属第一医院普外科收治胃脂肪瘤患者2例, 并检索1998-2008年底国内公开发表的胃脂肪瘤相关文献, 分析患者临床资料.结果: 国内近10年术后病理确诊为胃脂肪瘤的患者64例. 胃脂肪瘤在临床上十分少见, 临床表现缺乏特异性,前诊断首选CT和MRI,主要采用手术治疗, 预后较好.结论: 国内近10年在胃脂肪瘤的诊断与治疗方面有较大进展, 但是对于胃脂肪瘤的相关文献报道仍存在许多不足的地方.     

小肠长蒂脂肪瘤致复发性肠套叠1例

<正>脂肪瘤占全消化道良性肿瘤的约4%,发病率在0.15%～4.4%之间,通常单发且生长缓慢,多数位于结肠,其次是小肠,小肠中又以回肠多见,其次是空肠^[1-2]。多数患者无临床表现,而于手术或内镜检查、尸检时意外发现。随着胃肠镜体检筛查普及,胃、十二脂肠、结肠脂肪瘤易被发现,但当位于小肠时,因常规胃镜、结肠镜常无法到达,使其早期发现更为困难。病程初期可仅有反复腹痛、腹胀等不典型发作表现,后期出现急性合并症时可有消化道出血、肠梗阻、肠套叠、     

Submucous colon lipoma： A case report and review of the literature

Colon lipoma is remarkably rare in clinical practice. We reported a case of ascending colon lipoma in an 83-year-old woman. She was asymptomatic with a lipoma of 35 mm×30 mm×24 mm in size which was found by routine colonoscopy. Right hemicolectomy was performed uneventfully. The diagnosis was made by histological examination. Reviewing the literature and combining with our experience, we discussed the clinical features, diagnosis and treatment of this uncommon disease.     

支气管镜下高频电凝圈套加高频电凝治疗支气管脂肪瘤1例报道并文献复习

目的：了解支气管脂肪瘤的临床特征,提高对该病的认识。方法分析我科收治的1例经病理证实为支气管脂肪瘤患者的资料,并回顾性复习国内外相关的文献。结果患者男,78岁,表现为阻塞性肺炎伴咯血,胸部CT及三维重建提示脂肪瘤可能(CT 值为-100~-21 Hu),在全身麻醉下行支气管镜下高频电凝圈套加高频电凝切除术,术后支气管通畅,病理证实为脂肪瘤。结论支气管脂肪瘤为罕见的良性肿瘤,临床症状、体征无特异性,常表现为哮喘、阻塞性肺炎、COPD、肺癌等,误诊率达55.0%,确诊时间为11个月。诊断主要依靠胸部 CT 及三维重建和核磁共振成像,病理为确诊依据。治疗方法有外科手术和内镜下切除,切除的方法取决于肿瘤的大小和肺损伤的程度。镜下治疗支气管脂肪瘤是一项安全、有效、经济的治疗手段。     

Lipoma induced jejunojejunal intussusception

Intussusception in adults is rare. The clinical picture of intussusception in adults is subtle and the diagnosis is, therefore, elusive. The presence of a structural abnormality in the great majority of the adult cases mandates high clinical suspicion. Gastrointestinal lipomas are rare benign tumors and intussusception due to a gastrointestinal lipoma constitutes an infrequent clinical entity. The present report describes a case of jejunojejunal intussusception in an adult with a history of severe episodes of hematochezia and colicky upper abdominal pain. The diagnosis was suspected preoperatively but computed tomography scan could not rule out malignancy. Exploratory laparotomy revealed jejunojejunal intussusception secondary to a lipoma which was successfully treated with segmental intestinal resection.     

Pleural lipoma. Diagnosis by computed tomography

Until recently, a definitive diagnosis of lipoma in the thorax could only be established by thoracotomy. We undertook this study to determine if chest CT could provide such an answer. Among 4,000 chest CT scans, six patients were found to have lipoma according to the following selected criteria: CT features of a pleural mass; a lesion showing completely homogeneous density with CT numbers indicating fat, and exclusion of other fatty lesions. In these six patients, the lipoma was an incidental finding, four were men, the mean age was 64.3 years, one-half were obese, and none had chest pains or dyspnea. Lesions varied in size from 2 to 4 cm and occurred along the chest wall. The CT numbers of the masses ranged from -54 to -129. None developed malignancy. In conclusion, we recommend clinical and chest CT follow-up for the asymptomatic patient who fulfills our CT criteria for lipoma. Biopsy or resection is recommended for lesions that are inhomogeneous.     

Lipoma within inverted Meckel＇s diverticulum as a cause of recurrent partial intestinal obstruction and hemorrhage： A case report and review of literature

Lipoma within an inverted Meckel's diverticulum presenting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity.We report a case of 47-year-old male with a history of recurrent episodes of partial intestinal obstruction and melena due to a subserosal lipoma located in the base of an inverted Meckel's diverticulum.According to our knowledge,this is the first case of a lipoma within a Meckel's diverticulum giving rise to this clinical scenario without the existence of heterotrophic gastric or pancreatic tissues.     

Gastric Lipoma Presenting as Peptic Ulcer: Case Report and Review of the Literature

A 61-year-old housewife was diagnosed as having peptic ulcer disease for a period of 2 years. During this time she had episodes of abdominal cramping, dyspepsia, and one episode of severe upper gastrointestinal bleeding. She was subsequently found to have a large gastric lipoma. Gastric lipoma, a rare tumor, frequently mimics peptic ulcer disease in its clinical presentation and its complications. This point has not been previously emphasized.     

Calcaneal intraosseous lipoma: A rare cause of heel pain

BackgroundIntraosseous lipoma is a rare benign tumor representing 0.1% of all skeletal tumors. We report a new case of plantar heel pain revealing intraosseous lipoma of the calcaneus.Aim of the workTo increase clinical awareness of calcaneal lipoma and to highlight the contribution of imaging in the diagnosis of patients with persistent heel pain.Case reportA 67-years-old Tunisian man presented to the Rheumatology department, Kassab Orthopaedic Institute, Faculty of Medicine, University of Tunis el Manar with a four months history of persistent left heel pain. The pain became worse during walking and disappeared at rest. He had no history of trauma. The physical examination was normal, except for tenderness to palpation of the left heel. Radiography of the left heel showed a well-defined lesion in the neck of calcaneus. Magnetic resonance imaging (MRI) was performed and showed a large lesion in the left calcaneus, well demarcated (width: 30 mm, length: 33 mm and height: 18 mm), with high signal intensity on T1 and T2 weighted sequences and low signal in T2 sequences with fat saturation without enhancement after gadolinium injection. The diagnosis of calcaneal lipoma was established and the patient was put on symptomatic treatment and referred to surgery.ConclusionCalcaneal lipoma should be mentioned as a forerunner among the differential diagnoses of persistent heel pain and promptly dealt with for a promising outcome.