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。

Diagnosis and Treatment of Intestinal Lipoma

Background: Intestinal lipoma is an uncommon benign intestinal tumor. Preoperative diagnosis is difficult due to lack of specific clinical features. Aims: To analyze the main clinical manifestations and management of intestinal lipoma so as to improve the accuracy rate of its diagnosis and treatment. Methods: From Jan. 1993 to Jan. 2003, 7 patients were diagnosed as having intestinal lipoma in our hospital. A retrospective analysis was carried out on its clinical manifestations, diagnosis and treatment. Results: The main clinical manifestations of 6 intestinal lipoma patients were abdominal pain and (or) bloody stool, and one patient was asymptomatic. Six patients underwent colonoscopy or other examinations, but only one was correctly diagnosed. Six patients received surgical resection and recovered. The pathologic exam showed submucosal lipoma in 4 cases and intermural lipoma in two. Another asymptomatic patient diagnosed by colonoscopic biopsy was just followed up at regular intervals. Conclusions: Imaging diagnosis and colonoscopy are helpful in the preoperative diagnosis of intestinal lipoma. Selection of endoscopic electrosection or local intestinal resection can be determined by the size of the tumor, and the presence or absence of a pedicle.