A Small Bowel Volvulus Caused by a Mesenteric Lipoma: Report of a Case

Abstract

A 31-year-old man underwent a laparotomy for acute intestinal obstruction symptoms, which he had intermittently experienced for 14 years. The cause of the obstruction was due to a volvulus of the small bowel caused by a mesenteric lipoma. This is a rare finding, which is ideally diagnosed by computed tomography, with surgery the best and most highly recommended treatment. This particular presentation, to the best of our knowledge, has not yet been previously reported in the English language.

Primary Midgut Volvulus in Adults: Report of Two Cases and Review of the Literature

“…However, many other causes have been reported in case reports or series, including internal hernias, tumors, mesenteric lymph nodes, Meckel's diverticulum, mesenteric lipoma, mesenteric lymphangioma, pregnancy, endometriosis, abscess, mycobacterial disease, aneurysms, and hematomas. [9][10][11][12][13][14][15][16] Clinical presentation of primary midgut volvulus is usually nonspecific. An abrupt onset of signs and symptoms of small-bowel obstruction in a patient without previous abdominal surgery or other obvious causes (hernias), preceded by colicky epigastric or periumbilical pain several days before, should raise suspicion for this entity.…”

A small intestine volvulus caused by strangulation of a mesenteric lipoma: a case report

“…A lipoma can occur almost anywhere in the trunk, extremities, or even intraperitoneally, which is extremely rare with a small overall malignant potential [2]. The differential diagnosis is liposarcoma, which has a high recurrence rate.…”

A Rare Cause of Childhood Ileus: Giant Mesenteric Lipoma and a Review of the Literature

“…Lipomas are usually slow-growing, non-lobulated, soft and mobile masses that do not penetrate into surrounding organs [4]. The clinical picture of mesenteric lipomas usually presents as a partial obstruction due to compression or, rarely, a complete obstruction caused by intestinal volvulus [7][8][9]. The most common intestinal symptoms in these cases are anorexia, abdominal distention, weight loss, constipation, and a feeling of fullness that increases after meals.…”

“…As long as the bowel allows passage, mesenteric lipomas often do not cause gastrointestinal symptoms [5,6]. However, a few can cause symptoms consistent with a partial bowel obstruction, such as intermittent abdominal pain, abdominal distention, and vomiting, with very few resulting in intestinal volvulus or complete intestinal obstruction due to torsion [4,7,8]. These are usually reported as sporadic cases in the literature [2,4,5].…”