A pitfall in the diagnosis of acute abdomen causing by mesenteric lipoma

Abstract

Introduction: Mesenteric lipoma is an uncommon disease, infrequently reported in the literature. Presentation of case: We present the clinical data and imaging findings of a symptomatic case with mesenteric lipoma causing acute abdominal symptoms. On CT scan the lesion was imaged as a mass of Lipomatous appearance in connection with the mesentery, with fat infiltration and a medium-abundance effusion. Exploratory laparotomy revealed a 4 cm necrotic and pedunculated mass, in the mesentery of the ileum, with a spiral turn around its axis. Resection of the affected segment of the ileum and end to end ileal anastomosis were carried out. Anatomopathological examination confirmed the mesenteric lipoma. The post-operative outcome was uneventful. Discussion: Mesenteric lipoma is an uncommon tumor that can be asymptomatic or complicated by obstruction or volvulus leading to acute abdomen. Its diagnosis is challenging and is rarely made pre operatively. Conclusion: Mesenteric lipoma should always be considered as a differential diagnosis in a patient with recurrent features of abdominal symptoms and a mobile abdominal mass. Highlights