Terminal ileal lipoma

Posted By Wael Nemattalla
Terminal ileal lipoma

44 years old female. The lipoma was an incidental finding with no GIT symptoms.

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  • Wael Nemattalla 2014-01-05 09:55:51

    Small Bowel Lipoma



    General Considerations

    • Small bowel tumors are relatively rare, accounting for only 2% of all GI malignancies

    • Most lipomas of the GI tract occur in the colon, the small bowel being the 2nd most common site and accounting for about 25%

    • Usually solitary but may be multiple

    • Most small bowel lipomas are found in the ileum

    • Most often submucosal and may be pedunculated



    Clinical Findings

    • If small, usually no symptoms

    • When symptoms occur, they are non-specific and may include

    o Abdominal pain

    o Constipation

    o Diarrhea

    o Nausea and vomiting

    o GI hemorrhage (may be occult), especially when over 2 cm

    o Obstruction (in up to 30% of symptomatic patients)

    o Lead point of intussusception



    Imaging Findings

    • Conventional radiographs will be normal except when there is obstruction of the bowel

    • CT will show a low density mass in the wall of the small bowel

    o Homogeneous mass with Hounsfield units between −80 and –120

    • Upper GI series may show a submucosal mass with obtuse borders that may have barium collections in central ulcerations

    • The Lipoma may be noted to change its shape on different views owing to its pliability



    Differential Diagnosis

    • Adenomas

    • Carcinoid tumor

    • Intestinal polyposis syndromes



    Treatment

    • If symptomatic, they may be surgically removed





    Source:

    http://www.learningradiology.com/archives2012/COW%20533-Small%20Bowel%20Lipoma/sblipomacorrect.html

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