Duodenal Lipomatosis as a Curious Cause of Upper Gastrointestinal Bleed: A Report with Review of Literature

Zirpe, Dinesh; Wani, Majid; Tiwari, Priyanka; Ramaswamy, Palaniswamy Kalipatti; Kumar, Reddy Prasanna

doi:10.7860/jcdr/2016/19851.7881

Cited by 13 publications

(14 citation statements)

References 21 publications

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“…However, this diagnosis was not confirmed endoscopically because of the presence of ulcer formation and a reddish surface. Reports on gastric lipomas with ulcer formation 1,2,4 -9) describe that the increased tumor size engenders ischemia of the mucosal epithelium and that the mechanical stimulus of food and the effects of drugs are involved in the ulcer formation process 9,10) . Ulcerated gastric lipomas are generally large : more than 40 mm 1,2,8,9,11 -13) .…”

Section: Discussionmentioning

confidence: 99%

A case of gastric lipoma resected by endoscopic submucosa dissection with difficulty in preoperative diagnosis

Ichinose¹,

Hikichi

Kanno

et al. 2017

FJMS

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A 66 -year -old man was referred to our hospital with an increasing subepithelial lesion in the gastric antrum. Using esophagogastroduodenoscopy, a tumor with a steep, 20 -mm -high rise protruding in the lumen was observed. The mucosal surface of the tumor was reddish, with ulcers forming at the base. Moreover, the tumor was mobile and soft. A biopsy specimen was taken from the ulcer, but tumor tissue was not collected from the submucosa. Endoscopic ultrasonography (EUS) showed a high echoic mass in the submucosa. However, because the mucosal surface of the ulceration was red, the mesenchymal tumor with internal bleeding was inferred to be lipoma. Additionally, because the tumor was small, flexible, and soft, collecting tumor tissue under EUS -guided fineneedle aspiration was inferred as difficult. We were unable to make a final diagnosis because the lesion showed a small tumor with atypical macroscopic morphology. Therefore, endoscopic submucosa dissection (ESD) was chosen for the diagnostic treatment. Sodium hyaluronate sufficient for separation from the muscular layer was injected into the submucosa. Then submucosal dissection was performed just above the muscle layer. Results demonstrate the possibility of removing the tumor reliably without perforation. Pathological evaluation of the ESD specimen indicated a diagnosis of gastric lipoma.

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Section: Discussionmentioning

confidence: 99%

A case of gastric lipoma resected by endoscopic submucosa dissection with difficulty in preoperative diagnosis

Ichinose¹,

Hikichi

Kanno

et al. 2017

FJMS

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“…If duodenal polyps were found on EGD, the physicians would differentiate the Brunner's gland hamartoma from other types of multiple and sporadic polyps located at the duodenum according to the age of onset, distribution at the duodenum, endoscopic appearance, histological characteristics, and immunohistochemical markers (Table 3) [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63]. Nearly all cases with familial adenomatous polyposis can be accompanied by duodenal adenomas, and some of them have extraintestinal manifestations, such as jaw and tooth abnormalities, nasopharyngeal angiofibromas, and cutaneous lesions (i.e., lipomas, fibromas, and sebaceous and epidermoid cysts) [58].…”

Section: Diagnostic Approachesmentioning

confidence: 99%

Brunner’s Gland Hamartoma of the Duodenum: A Literature Review

Zhu

et al. 2021

Adv Ther

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Brunner's gland hamartoma is a benign tumor of the duodenum, but has malignant potential with a very low risk of progression into adenocarcinoma. It is uncommon with a frequency of less than 1.0% among the primary tumors of the small intestine. In addition, its clinical manifestations are nonspecific, etiology remains unclear, and treatment strategy needs to be further refined. This literature review mainly discusses the epidemiology, clinical features, possible etiology and pathogenesis, diagnostic methods, malignant potential, treatment, and prognosis of Brunner's gland hamartoma.

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“…Lipomas are benign, fatty gastrointestinal (GI) tumors, more commonly located in the colon (64%)[1], the small intestine being the second site, and very rarely in the jejunum (< 2%)[2]. Usually, small bowel lipomas are asymptomatic, uncomplicated and discovered incidentally during investigation for other abdominal diseases such as an obstructive bowel syndrome or GI bleeding[2,3].…”

Section: Introductionmentioning

confidence: 99%

Ulcerated intussuscepted jejunal lipoma-uncommon cause of obscure gastrointestinal bleeding: A case report

Cuciureanu

Huiban

Chiriac

et al. 2019

WJCC

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BACKGROUNDIntestinal lipomas are rare benign gastrointestinal (GI) tumors, usually asymptomatic, but may become symptomatic as the result of some complications such as intussusception, intestinal obstruction, volvulus or bleeding. They can occur at any site along the entire GI tract, more frequent in colon and rarely in small intestine. The patient reported here is a very rare case of jejunal lipoma, ulcerated and intussuscepted, diagnosed in an adult investigated for a chronic iron deficiency anemia (IDA), and successfully managed by segmental jejunal resection.CASE SUMMARYA 63-year-old male was referred to “St. Spiridon” Hospital, Institute of Gastroenterology and Hepatology, Iasi, to investigate an obscure GI bleeding with an IDA. After upper GI endoscopy and colonoscopy were performed, excluding potentially bleeding lesions, videocapsule endoscopy was then carried out, revealing fresh blood and a protruding lesion in proximal jejunum, findings confirmed by a single-balloon enteroscopy. Multiple biopsies were taken from the lesion, but histological results were inconclusive. Then, contrast - enhanced computed tomography was performed showing jejunal polypoid mass with homogenous fat density, suggestive for lipoma. A week later a laparotomy was performed revealing the intussuscepted jejunal segment which was resected en bloc, and sent for further histopathologic analysis. The patient made an uneventful recovery and was discharged seven days later, and at six months follow-up he had no complains and his hemoglobin returned to normal value.CONCLUSIONLipomas are very rarely located in the jejunum, usually asymptomatic, but they may lead to complications such as intussusception and bleeding. Surgical resection remains the treatment of choice.

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Duodenal Lipomatosis as a Curious Cause of Upper Gastrointestinal Bleed: A Report with Review of Literature

Cited by 13 publications

References 21 publications

A case of gastric lipoma resected by endoscopic submucosa dissection with difficulty in preoperative diagnosis

A case of gastric lipoma resected by endoscopic submucosa dissection with difficulty in preoperative diagnosis

Brunner’s Gland Hamartoma of the Duodenum: A Literature Review

Ulcerated intussuscepted jejunal lipoma-uncommon cause of obscure gastrointestinal bleeding: A case report

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