Laparoscopic Management of a Large Duodenal Lipoma Presented as Gastric Outlet Obstruction

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Abstract

Laparoscopic excision of duodenal lipoma may be an effective alternative when endoscopic excision is not feasible.

Abstract

Lipoma of the duodenum is a rare tumor, with fewer than 230 cases reported to date. A majority of these tumors were managed by endoscopic and open surgical intervention, with published data on one case that was managed by total laparoscopy. We report a case of a 43-year-old woman with signs and symptoms of gastric outlet obstruction who was diagnosed as having a large duodenal lipoma that was managed successfully with laparoscopic excision.

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Most cited references 7

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Lipoma of the alimentary tract.

Lisa Mayo, R J PAGTALUNAN, Geoffrey D. Brown (1963)

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A safe and efficient strategy for endoscopic resection of large, gastrointestinal lipoma.

H. Luo, Y. Ding, H Yu … (2007)

Gastrointestinal (GI) lipomas are benign, slowly growing, submucosal tumors, which may cause gastrointestinal bleeding, anemia, intussusception, and bowel obstruction. The aim of this study is to explore the safe and effective strategy for endoscopic removal of large GI lipomas. During last 10 years, fifteen large and symptomatic GI lipomas were resected under endoscopy in our hospital. In them, two large lipomas with small stalk (< 2 m in diameter) were resected by polypectomy; ten large lipomas with base size greater than 2 cm in diameter were removed using a "subtotal resection." Three other large lipomas with small stalk (< 2 m in diameter) were resected by multistep resection. Endoscopic ultrasonography (EUS) and miniprobe endoscopic ultrasound were performed in six cases from January 2000 to July 2004 to confirm that those lesions were lipomas that were superficial to the muscularis propria. All 15 lesions were successfully removed and were histopathologically confirmed to be lipomas. No severe complications, such as perforation or hemorrhage, developed after endoscopic removal. No recurrence was observed after 1-8 years follow-up endoscopic examination. Various, large GI lipomas can be removed safely by electrosurgical snare resection under endoscopy following the guidance of the present therapeutic strategy.

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Lipomatous tumors of the abdominal cavity: CT appearance and pathologic correlation.

Zachary Stephens, M P Waligore, Steven McLeod … (1981)

Twenty patients with pathologically confirmed extraparenchymal intraabdominal lipomatous tumors, including two lipomas, two cases of diffuse infiltrating lipomatosis, and 16 liposarcomas, were examined by computed tomography (CT). The CT appearance of these tumors closely correlated with their gross and microscopic pathologic anatomy. Distinctive CT features differentiated simple lipomas from diffuse infiltrating lipomatosis and from liposarcomas. The densities of these tumors, including the variable densities of liposarcomas, were explained by their tissue composition. Lipomas, diffuse infiltrating lipomatosis, and lipogenic liposarcomas were predominantly of fat density, whereas myxoid liposarcomas were of a higher range of densities. Liposarcomas often contained more than one type of tumor tissue, resulting in masses of distinctly different densities coexisting within the same tumor. CT accurately depicted the presence, location, and size of the tumors and provided information about their relation to adjacent structures.

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Contributors

Department of Minimal Access Surgery, Apollo Hospital, Chennai, Tamil Nadu, India.

Journal

Journal ID (nlm-ta): JSLS

Journal ID (iso-abbrev): JSLS

Journal ID (hwp): jsls

Journal ID (pmc): jsls

Journal ID (publisher-id): JSLS

Title: JSLS : Journal of the Society of Laparoendoscopic Surgeons

Publisher: Society of Laparoendoscopic Surgeons (Miami, FL )

ISSN (Print): 1086-8089

ISSN (Electronic): 1938-3797

Publication date (Print): Jul-Sep 2013

Volume: 17

Issue: 3

Pages: 459-462

Affiliations

Department of Minimal Access Surgery, Apollo Hospital, Chennai, Tamil Nadu, India.

Author notes

Address correspondence to: Prof. Prasanna Kumar Reddy, Department of Minimal Access Surgery, Apollo Hospital, Kilpauk, Chennai, Tamil Nadu, India. Telephone: (91) 984-006-4123, E-mail: drpkreddy@ 123456gmail.com

Article

Publisher ID: 12-02-040

DOI: 10.4293/108680813X13654754535395

PMC ID: 3771769

PubMed ID: 24018087

SO-VID: 9a1b3ce8-ac41-4071-adea-3da2306b8108

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License ( http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.

Laparoscopic Management of a Large Duodenal Lipoma Presented as Gastric Outlet Obstruction

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Abstract

Abstract

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Most cited references 7

Lipoma of the alimentary tract.

A safe and efficient strategy for endoscopic resection of large, gastrointestinal lipoma.

Lipomatous tumors of the abdominal cavity: CT appearance and pathologic correlation.

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