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Small Bowel Bleeding Caused by a Small Bowel Lipoma in a Patient with Hemodialysis
Shunsuke Yamagishi1, Woodae Kang1, Masataka Shindate1
1Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, Ichikawa Hospital, International University of Health and Welfare School of Medicine, Chiba, Japan.
Introduction:
Small bowel bleeding is being diagnosed with increasing frequency with the development of capsule endoscopy.
Case Presentation:
We report a case of lipoma that caused hematochezia in an 80-year-old woman with ischemic heart disease receiving antiplatelet therapy and on hemodialysis for renal failure. Contrast-enhanced computed tomography scans, esophagogastroduodenoscopy, and colonoscopy failed to identify the source of hematochezia. Capsule endoscopy revealed a small bowel tumor, which was removed through laparoscopic surgery without interruption of antiplatelet agents. The small bowel tumor was pathologically diagnosed as a lipoma. There was no recurrence of the hematochezia after surgery.
Conclusion:
Lipomas could cause hematochezia. With appropriate preoperative testing, comorbidity assessment, and surgical planning, we believe that surgical resection is a safe treatment option for the removal of small bowel lipomas even in patients who are on hemodialysis or are taking antiplatelet agents.
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