Jejunal Intussusception of a Gastric Lipoma: A Review of Literature

Mouës, Chantal M.; Steenvoorde, P.; Viersma, J.H.; Groningen, K. van; Bruïne, J.F. de

doi:10.1159/000065825

Cited by 18 publications

(5 citation statements)

References 9 publications

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“…This difference is consistent with replacement of UGI series by EGD and abdominal CT which provide superior characterization. In 9 (82%) of 11 cases abdominal ultrasound showed features suspicious for lipomas of a well-demarcated, submucosal, hyperechoic lesion, but the lesion was missed in 2 cases[ 4 , 9 , 11 , 16 , 19 , 20 , 22 , 26 , 27 , 29 , 30 ]. These results are consistent with abdominal ultrasound being a cheaper, but less definitive test than abdominal CT for giant gastric lipomas.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of giant gastric lipomas reported since 1980 and report of two new cases in a review of 117110 esophagogastroduodenoscopies

Cappell¹,

Stevens²,

Amin³

2017

WJG

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AIMTo systematically review the syndrome of giant gastric lipomas, report 2 new illustrative cases.METHODSLiterature systematically reviewed using PubMed for publications since 1980 with following medical subject heading/keywords: (“giant lipoma”) AND (“gastric”) OR [(“lipoma”) and (“gastric”) and (“bleeding”)]. Two authors independently reviewed literature, and decided by consensus which articles to incorporate. Computerized review of pathology/endoscopy records at William Beaumont Hospitals, Royal Oak and Troy, Michigan, January 2005-December 2015, revealed 2 giant gastric lipomas among 117110 consecutive esophagogastroduodenoscopies (EGDs), which were thoroughly reviewed, including re-review of original endoscopic photographs, radiologic images, and pathologic slides.RESULTSGiant gastric lipomas are extremely rare: 32 cases reported since 1980, and 2 diagnosed among 117110 consecutive EGDs. Average patient age = 54.5 ± 17.0 years old (males = 22, females = 10). Maximal lipoma dimension averaged 7.9 cm ± 4.1 cm. Ulcerated mass occurred in 21 patients. Lipoma locations: antrum-17, body-and-antrum-4, antrum-intussuscepting-into-small-intestine-3, body-2, fundus-1, and unspecified-5. Intramural locations included submucosal-22, subserosal-2, and unspecified-8. Presentations included: acute upper gastrointestinal (UGI) bleeding-19, abdominal pain-5, nausea/vomiting-5, and asymptomatic-3. Symptoms among patients with UGI bleeding included: weakness/fatigue-6, abdominal pain-4, nausea/vomiting-4, early-satiety-3, dizziness-2, and other-1. Their hemoglobin on admission averaged 7.5 g/dL ± 2.8 g/dL. Patients with GI bleeding had significantly more frequently ulcers than other patients. EGD was extremely helpful diagnostically (n = 31 patients), based on characteristic endoscopic findings, including yellowish hue, well-demarcated margins, smooth overlying mucosa, and endoscopic cushion, tenting, or naked-fat signs. However, endoscopic mucosal biopsies were mostly non-diagnostic (11 of 12 non-diagnostic). Twenty (95%) of 21 abdominal CTs demonstrated characteristic findings of lipomas, including: well-circumscribed, submucosal, and homogeneous mass with attenuation of fat. Endoscopic-ultrasound showed characteristic findings in 4 (80%) of 5 cases: hyperechoic, well-localized, mass in gastric-wall-layer-3. Transabdominal ultrasound and UGI series were generally less helpful. All 32 patients underwent successful therapy without major complications or mortality, including: laparotomy and full-thickness gastric wall resection of tumor using various surgical reconstructions-26; laparotomy-and-enucleation-2; laparoscopic-transgastric-resection-2; endoscopic-mucosal-resection-1, and other-1. Two new illustrative patients are reported who presented with severe UGI bleeding from giant, ulcerated, gastric lipomas.CONCLUSIONThis systematic review may help standardize the endoscopic and radiologic evaluation and therapy of patients with this syndrome.

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Section: Resultsmentioning

confidence: 99%

Systematic review of giant gastric lipomas reported since 1980 and report of two new cases in a review of 117110 esophagogastroduodenoscopies

Cappell¹,

Stevens²,

Amin³

2017

WJG

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“…Simple manual reduction and mass excision after gastrotomy has been reported for the gastroduodenal intussusception of benign tumors. 4,5 Resection of the intussusceptum depending on bowel viability and anastomosis revision has also been used to treat intussusceptions after gastric surgery. 7,8 In the present case, the issue of greatest concern was the gastric cancer, and thus, manual reduction was not performed in order to avoid intraluminal seeding, venous tumor dissemination, and peritoneal cavity perforation with subsequent microorganism and tumor cell seeding.…”

Section: Discussionmentioning

confidence: 99%

“…Most involve gastroduodenal intussusceptions associated with an anatomical abnormality or gastrojejunal intussusception after gastric surgery. [4][5][6][7][8] Gastrogastric intussusception is an extremely rare condition. We herein describe a unique case of gastrogastric intussusception secondary to a gastric cancer, which presented with the primary complaints of vomiting and poor oral intake.…”

Section: Introductionmentioning

confidence: 99%

Gastrogastric intussusception secondary to a gastric carcinoma: Report of a case

Eom

Lee²,

Lee³

et al. 2011

Surg Today

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Intussusception is uncommon in the proximal gastrointestinal tract, although a few case reports have been published on gastroduodenal intussusception associated with an anatomical abnormality or intussusceptions at a site of gastrojejunostomy after gastric surgery. We herein present a case of gastrogastric intussusception secondary to a gastric cancer, which presented as vomiting and poor oral intake. A 73-year-old woman was diagnosed with gastric cancer during a cancer screening by esophagogastroduodenoscopy and biopsy. Twenty days later, she presented with acute vomiting, a high fever, an increased heart rate, and severe anemia. Esophagogastroduodenoscopy demonstrated that the mass had been intussuscepted into the gastric lumen and distorted the distal antrum of the stomach. Standard distal subtotal gastrectomy was performed without reduction. Her postoperative course was uneventful.

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“…Polyps constitute 40%, intramural smooth muscle tumours constitute another 40% and benign lesions comprise the remaining 20% (1). Gastric lipomas account for only 5% of all gastrointestinal lipomas and are usually seen in the body or antrum of the stomach (3). They rarely present as an intussusception.…”

Section: Discussionmentioning

confidence: 99%

Gastrodudenal Intussusception Secondary to a Gastric Lipoma

Vinces

Ciacci

Sperling

et al. 2005

Canadian Journal of Gastroenterology

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Gastroduodenal intussusception caused by a gastric lipoma is an uncommon condition, and only a few cases have been reported in the medical literature. A case of a 72-year-old man who complained of weight loss and intermittent episodes of nausea and vomiting is presented. Diagnostic workup demonstrated a mass in the second portion of the duodenum. The patient underwent a diagnostic laparoscopy followed by an exploratory laparotomy that confirmed the gastroduodenal intussusception by a gastric lipoma. In addition, the anatomical and clinical presentation, diagnosis and management of this entity are discussed.

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Jejunal Intussusception of a Gastric Lipoma: A Review of Literature

Cited by 18 publications

References 9 publications

Systematic review of giant gastric lipomas reported since 1980 and report of two new cases in a review of 117110 esophagogastroduodenoscopies

Systematic review of giant gastric lipomas reported since 1980 and report of two new cases in a review of 117110 esophagogastroduodenoscopies

Gastrogastric intussusception secondary to a gastric carcinoma: Report of a case

Gastrodudenal Intussusception Secondary to a Gastric Lipoma

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