Laparoscopic resection of small bowel lipoma causing obscure gastrointestinal bleeding

Abstract

Small bowel lipomas are rare gastrointestinal benign neoplasms, whose signs and symptoms are often obscure. When symptoms are clinically present, one of the most common is usually gastrointestinal (GI) bleeding. It is very difficult to make a precise preoperative diagnosis in the absence of evident signs. Definitive diagnosis can only be made through histopathological examination, after the surgical resection. We report a case of obscure and persistent GI bleeding in a 78-year-old woman. Through the combination of endoscopy and computed tomography (CT), it was possible to identify a small bowel lesion, being its direct cause. CT showed a certain fat component within the mass pinpointing the hypothesis of a lipoma. We then performed a laparoscopic resection of 21 cm of the middle jejunum, including the mass and an intussusception. The results of the subsequent histopathological examination of the resected specimen allowed us to conclude that the lesion was an intestinal lipoma. Surgical resection appears to be the most successful approach as good short- and long-term results are achieved.