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Case Reports
. 2024 Jun 28:14:1415211.
doi: 10.3389/fonc.2024.1415211. eCollection 2024.

A case report of small intestinal volvulus caused by lipomatosis of the small intestine successfully treated with enterectomy

Affiliations
Case Reports

A case report of small intestinal volvulus caused by lipomatosis of the small intestine successfully treated with enterectomy

Hao Qin et al. Front Oncol. .

Abstract

Small intestinal lipomatosis is a rare condition that presents a diagnostic challenge due to the absence of identifiable clinical symptoms and limitations of small intestine examination methods. Consequently, preoperative diagnosis is difficult and only a limited number of cases have been documented in the scientific literature. Here, we report a rare case of volvulus caused by small intestinal lipomatosis. A 58-year-old female patient was tentatively diagnosed with acute ileus. The whirl sign was detected using abdominal three-dimensional enhanced computed tomography, along with marked local intestinal dilation and multiple irregular fat-like containing lesions. During surgery, abnormal dilation of the small intestine between 80 and 220 cm from the ileocecal valve was detected and the affected intestine displayed a folded and twisted configuration. Examination of the resected intestine showed that the inner wall of the diseased intestinal lumen was covered with more than 100 lipomas of different sizes, the largest of which measured ~8.0 cm in diameter. Based on clinical symptoms alone, it was difficult to identify the cause of intestinal volvulus before surgery. Complete resection of the affected small intestine and subsequent pathological analysis yielded a definitive diagnosis of small intestinal lipomatosis. While small intestinal lipomatosis is a rare condition, prognosis is favorable if diagnosed early and treated appropriately. The application of three-dimensional enhanced computed tomography imaging can aid in accurate diagnosis, while complete resection of the affected small intestine is crucial to improve patient prognosis.

Keywords: intestinal volvulus; lipomatosis; resection; small intestinal tumor; small intestine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Preoperative three-dimensional enhanced abdominal CT (transverse view (A), coronal view (B) Multiple, irregular lipoid-like density foci (indicated by red arrow) can be seen in the enlarged small intestinal cavity, that showed no enhancement on the enhanced CT scan. (C) The small intestine appears swirling (red arrow).
Figure 2
Figure 2
The gross specimen revealed lipomas of different sizes densely covering the inner wall of the diseased intestinal cavity.
Figure 3
Figure 3
Pathological examination showed a submucosal lesion that was composed of mature adipose tissue (HE staining, A×50, B×100).
Figure 4
Figure 4
Three-dimensional enhanced abdominal CT scan (A transverse view, B coronal view) 20 months after surgery: no recurrence of small intestinal lipomatosis was observed.

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