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Submucous large-bowel lipomas--presentation and management. An 18-year study
M A Rogy1, D Mirza, G Berlakovich
1Department of Surgery I, University of Vienna Medical School, Austria.
The European Journal of Surgery = Acta Chirurgica
|January 1, 1991
Summary
Large-bowel lipomas, though rare, are typically submucosal tumors in the colon or rectum. Early diagnosis, especially with CT scans, can prevent unnecessary surgeries for symptomatic gastrointestinal lipomas.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Gastrointestinal lipomas are uncommon benign tumors, most frequently found in the colon and rectum.
- These lipomas are typically submucosal, rarely subserosal, and can present with various symptoms or be asymptomatic.
Purpose of the Study:
- To analyze the clinical presentation, diagnostic methods, and management of large-bowel lipomas over an 18-year period.
- To evaluate the diagnostic accuracy of different imaging modalities for gastrointestinal lipomas.
- To assess the potential for endoscopic removal to avoid surgical intervention in symptomatic cases.
Main Methods:
- Retrospective analysis of 17 cases of large-bowel lipoma diagnosed over 18 years.
- Review of patient symptoms, tumor characteristics, and diagnostic procedures including barium enema, colonoscopy, and CT scans.
- Examination of surgical specimens for accurate diagnosis and comparison with pre-operative findings.
Main Results:
- 17 patients had 21 submucosal lipomas, predominantly in the ileocecal valve, cecum, rectum, sigmoid, and descending colon.
- Symptomatic patients (13) experienced pain, discomfort, bleeding, or altered bowel habits, with larger average tumor size (3.5 cm) compared to asymptomatic patients (1.8 cm).
- Diagnostic accuracy varied, with CT correctly identifying all lipomas in which it was used, while other methods frequently misdiagnosed lipomas as polyps or angiodysplasia.
Conclusions:
- Accurate diagnosis of large-bowel lipomas is crucial, with CT demonstrating high diagnostic efficacy.
- Endoscopic removal of symptomatic gastrointestinal lipomas can potentially prevent the need for invasive surgery like colotomy or colonic resection.