Multiple Duodenal Lipomas as a Rare Cause of Upper Gastrointestinal Obstruction: Case Report and Literature Review

Abstract

Duodenal lipomas are rare benign tumors and pose a diagnostic challenge as their symptoms are non-specific. In this article, we reported a case of duodenal lipoma presenting as upper gastrointestinal obstruction and reviewed the literature on relevant clinical manifestation, diagnosis and treatment. Our review of literature indicated that multiple duodenal lipomas as a cause of upper gastrointestinal obstruction as reported here are extremely rare. The preoperative computed tomography and magnetic resonance imaging are the key to diagnosis, and surgical resection is the most effective means for the management of such duodenal lipomas.

An Incidental Upper Gastrointestinal Lesion: Duodenal Lipoma

“…It can only suggests the presence of submucosal protruding lesion, but cannot provide further characterization of the lesion 6,7 . Current imaging modalities such as CT and MRI can farely accurately provide the diagnosis of lipoma based on low attenuation ranging from -60 to -120 HU on CT, corresponding with the density of fat 8 . In the present case, the lesion were noted on CT with a value of -60 to -125 HU which is typical of lipomas.…”

“…Lipomas show no contrast enhancement. Though CT and MRI are helpful in diagnosis, they are unable the locate the origin of the lesion 8 . Endoscopic ultrasound (EUS) provides information about the original layer, echogenicity, depth and invasion 4 .…”

“…adenocarcinoma, neuroendocrine tuomors, stromal tumors, lymphoma), benign duodenal mass-forming lesions (e.g. adenoma, polyposis syndromes, leiomyomas, Brunner's gland hyperplasia and hamartoma) should be considered primarily 5,6,7,8 .…”

Diffuse Jejunal Lipomatosis and Associated Complications

“…Case reports from across the globe have previously associated small intestinal lipomatosis with various causes of intestinal obstruction, diverticulosis, intestinal bleeding, intestinal infarction, malabsorption, and small intestinal bacterial overgrowth (SIBO). [4][5][6][7][8][9][10][11][12] Here, we present the case of a man with diffuse jejunal lipomatosis and chronicle his disease progression with multiple complications.…”

Mesenteric lipoma with small bowel volvulus: A rare cause of upper gastrointestinal obstruction (a case report and literature review)

“…Lipomas are benign neoplasms of adipose tissue that can occur almost anywhere [1] . Small bowel lipomas are rare and uncommon while small bowel obstructions are due essentially to the band after surgery; the occlusion of small bowel occlusion after strangulation due to mesenteric lipomas is very rare [2] .…”