Giant Mesenteric Lipoma Causing Small Bowel Volvulus: A Case Report

Abstract

BACKGROUND: A lipoma of the small bowel mesentery is a rare clinical entity. It rarely causes intestinal obstruction mainly due to volvulus.CASE: We report a case of a 25 years old male who presented with acute exacerbation of abdominal pain, nausea and vomiting. Plain abdominal x-ray showed complete small bowel obstruction. At laparotomy, there was small bowel volvulus with a big yellow mass as an axis. Enbloc resection and end-to-end ileal anastomosis was done.CONCLUSION; Mesenteric lipoma are rare. They should be considered in cases of long standing abdominal pain.

Giant Mesenteric Lipoma in an Adult

“…Lipomas that produce volvulus or torsion are relatively smaller than those causing compressive symptoms. 4 , 7 , 8 …”

Mesenteric lipoma: a rare cause of acute small bowel obstruction

“…Mesenteric lipomas are rare clinical entities, with less than 30 cases documented in literature till 2009 and about 50 cases till 2014. 3,4 They are commoner in adults aged between 40 and 60 years and rarely occur in children of less than 10 years. 4 The predisposing factors include obesity, diabetes mellitus, hypercholesterolemia and chromosomal translocation.…”

“…3,4 They are commoner in adults aged between 40 and 60 years and rarely occur in children of less than 10 years. 4 The predisposing factors include obesity, diabetes mellitus, hypercholesterolemia and chromosomal translocation. 3,5 The clinical presentation of lipomas range from asymptomatic incidental finding, progressive abdominal swelling, or rarely as acute bowel obstruction.…”

“…3,5 The clinical presentation of lipomas range from asymptomatic incidental finding, progressive abdominal swelling, or rarely as acute bowel obstruction. 4 These lipomas being soft and mobile masses which do not infiltrate into surrounding structures, allow passage of small bowel contents and hence, are usually asymptomatic. 6 In symptomatic patients, the common symptoms are vague abdominal pain, distension, and anorexia and weight loss, usually related to the pressure effects of lipoma.…”

“…6 In symptomatic patients, the common symptoms are vague abdominal pain, distension, and anorexia and weight loss, usually related to the pressure effects of lipoma. 4 Rarely, patients present with signs and symptoms of intermittent or acute intestinal obstruction, usually due to small bowel volvulus or intussusceptions caused by the lipoma.…”