An unusual cause of recurrent abdominal pain in a middle-aged man

Rev Esp Enferm Dig. 2023 Aug 4. doi: 10.17235/reed.2023.9879/2023. Online ahead of print.

Abstract

A 54-year-old man was hospitalized with intermittent periumbilical pain for 1-month duration. Abdominal contrast-enhanced computed tomography (CT) revealed target-sign and a fat density mass measuring 2.0 × 2.5-cm in the distal ileum. Part mesenteric tissues and blood vessels were embedded and the wall of the affected intestinal tube was thickened and edematous. His symptom was alleviated after conservative treatment and he refused further management. The patient was hospitalized again with the same symptoms and abdominal CT findings 4 years later. Exploratory laparotomy was performed. A palpable mass in the ileum was found measuring 3.0 × 3.0-cm and partial enterectomy was performed. Postoperative histopathology revealed the resected mass was composed of proliferating mature adipocytes surrounded by few fibrous connective tissue. Hyperplastic fibroblast and inflammatory exudative necrotic tissue were found on the surface of the mass. The patient was diagnosed as ileum fibrolipoma with intussusception. He was discharged home uneventfully and no symptoms was observed in 12 months follow-up.