Colonoscopy-assisted laparoscopic wedge resection for a large symptomatic colonic lipoma

BMJ Case Rep. 2024 Apr 24;17(4):e258947. doi: 10.1136/bcr-2023-258947.

Abstract

A colonic lipoma is an uncommon lesion that is linked with clinical symptoms in only a small portion of patients. Patients with large lipomas are often referred for major surgery, which is associated with significant morbidity and mortality. In this case, we described a female patient with recurrent episodes of gastrointestinal blood loss, abdominal pain and colocolic intussusceptions due to a large, lumen-filling, obstructive lipoma in the splenic flexure. On abdominal CT, a lesion of 3.6 cm was visualised with a fat-like density without solid components. Considering its benign nature, we intended to preserve the colon by deroofing the upper part of the lesion and then performing a colonoscopy-assisted laparoscopic wedge resection. During reassessment, auto-amputation of part of the lesion was observed, most likely as a result of long-lasting mechanical effects, which made it possible to perform solely a wedge resection with an excellent outcome.

Keywords: Endoscopy; GI bleeding; Gastroenterology; Gastrointestinal surgery.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Colonic Neoplasms* / diagnosis
  • Colonic Neoplasms* / diagnostic imaging
  • Colonic Neoplasms* / surgery
  • Colonoscopy* / methods
  • Female
  • Humans
  • Intussusception / diagnosis
  • Intussusception / diagnostic imaging
  • Intussusception / surgery
  • Laparoscopy* / methods
  • Lipoma* / diagnostic imaging
  • Lipoma* / surgery
  • Middle Aged
  • Tomography, X-Ray Computed
  • Treatment Outcome