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      Lipoma colónico e intususcepción intestinal: Reporte de un caso y revisión de la literatura Translated title: Colonic lipoma and intestinal intussusception: Report of a case and review of the literature

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          Abstract

          Resumen Los lipomas son el segundo tumor benigno más frecuente que afecta el colon, existe predominio en el género femenino, siendo la edad de presentación más frecuente la sexta y séptima década de la vida. Las manifestaciones clínicas comprenden un amplio espectro de pacientes desde aquellos en que se encuentran incidentalmente, hasta pacientes que debutan con complicaciones que amenazan la vida. A pesar del avance en los métodos de estudio actuales, el diagnóstico continúa siendo un reto para el cirujano general, repercutiendo de manera crucial en el pronóstico de los pacientes, debido a la necesidad de un alto índice de sospecha para evitar cirugías amplias que aumenten la morbimortalidad del paciente. Se comenta el caso de una paciente con lipoma colónico que se presentó como una invaginación intestinal y datos de abdomen agudo, a la que se le realizó una hemicolectomía derecha.

          Translated abstract

          Abstract Lipomas are the second most common benign tumor of the colon, there is a predominance in females, being the most common age of presentation the sixth and seventh decade of life. Clinical manifestations include a wide range of patients from those who are incidentally, to patients presenting with life-threatening complications. Despite progress in the current methods of study, the diagnosis remains a challenge for the general surgeon, an impact crucially on the prognosis of patients due to the need for a high index of suspicion to avoid extensive surgery to increase patient morbidity and mortality. The case of a patient with colonic lipoma that presented as intussusception and data of acute abdomen, which underwent a right hemicolectomy is discussed.

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          Most cited references37

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          Adult intussusception: a retrospective review of 41 cases.

          To optimize the preoperative diagnosis and surgical management of adult intussusception (AI). A retrospective review of the clinical features, diagnosis, management and pathology 41 adult patients with postoperative diagnoses of intussusception was conducted. Forty-one patients with 44 intussusceptions were operated on, 24.4% had acute symptoms, 24.4% had subacute symptoms, and 51.2% had chronic symptoms. 70.7% of the patients presented with intestinal obstruction. There were 20 enteric, 15 ileocolic, eight colocolonic and one sigmoidorectal intussusceptions. 65.9% of intussusceptions were diagnosed preoperatively using a computed tomography (CT) scan (90.5% accurate) and ultrasonography (60.0% accurate, rising to 91.7% for patients who had a palpable abdominal mass). Coloscopy located the occupying lesions of the lead point of ileocolic, colocolonic and sigmoidorectal intussusceptions. Four intussusceptions in three patients were simply reduced. Twenty-one patients underwent resection after primary reduction. There was no mortality and anastomosis leakage perioperatively. Except for one patient with multiple small bowel adenomas, which recurred 5 mo after surgery, no patients were recurrent within 6 mo. Pathologically, 54.5% of the intussusceptions had a tumor, of which 27.3% were malignant. 9.1% comprised nontumorous polyps. Four intussusceptions had a gastrojejunostomy with intestinal intubation, and four intussusceptions had no organic lesion. CT is the most effective and accurate diagnostic technique. Colonoscopy can detect most lead point lesions of non-enteric intussusceptions. Intestinal intubation should be avoided.
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            Lipomas of the large bowel.

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              Giant submucosal lipoma located in the descending colon: a case report and review of the literature.

              Colonic lipoma is an uncommon tumor of the gastrointestinal tract. Most cases are asymptomatic, with a small tumor size, and do not need any special treatment. However, we encountered one patient with a giant submucosal lipoma, with a maximum diameter of 8.5 cm, which exhibited symptoms such as intermittent lower abdominal pain, changes in bowel habits with passage of fresh blood and mucus per rectum, abdominal distension, anorexia and weight loss. Unfortunately, the possibility of colonic malignancy could not be precluded and left hemicolectomy was planned. The exact diagnosis of this special case was accomplished by intraoperative pathology. In the end, local resection was performed instead of left hemicolectomy. To the best of our knowledge, colonic lipoma exceeding 8 cm in diameter has not been previously reported. We, therefore, present this case and discuss age and sex factors, clinical and histopathological findings, diagnostic methods and treatment by reviewing the available literature, to serve as a reminder that colonic lipoma can also exist in patients with significant symptoms. In addition, intraoperative pathology should be investigated in those doubtful cases, so as to guide the exact diagnosis and treatment plan.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                cg
                Cirujano general
                Cir. gen
                Asociación Mexicana de Cirugía General A.C. (México, DF, Mexico )
                1405-0099
                2014
                : 36
                : 2
                : 107-111
                Affiliations
                [1] orgnameUniversidad Nacional Autónoma de México orgdiv1Facultad de Medicina Mexico
                Article
                S1405-00992014000200107
                1b7dcb13-3e1a-4941-82ef-c631f5b28398

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 39, Pages: 5
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                SciELO Mexico


                Colonic lipoma,Intussusception,Hemicolectomía,Abdomen agudo,Invaginación intestinal,Lipoma colónico,Hemicolectomy,Acute abdomen

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