Torsion of an abdominal-wall pedunculated lipoma: a rare differential diagnosis for right iliac fossa pain

Laparoscopic extraction of a symptomatic upper abdominal pedunculated parietal peritoneal lipoma arising intermittent abdominal pain: a case report

INTRODUCTION

Lipomas arising in the parietal peritoneum are rare, and some of them cause abdominal pain due to torsion of the pedunculated peritoneum. We encountered a case of parietal peritoneal lipoma arising upper peritoneum. In this report, we describe the detail of clinical presentation and discuss its potential pathogenesis and treatment strategy.

CASE PRESENTATION

45 year-old Japanese female patient presented with long-lasting intermittent pain in the left upper abdominal region. Abdominal imaging showed a well-defined fatty mass measuring 40 mm in size, suggesting a parietal peritoneal lipoma. Laparoscopy revealed a tumor with a twisted peduncle; however, no adhesion of the surrounding tissues and ischemic changes were visible. The tumor was easily removed by dissection of the tumor pedicle.

CONCLUSION

Parietal peritoneal lipoma often shows pedunculated form and it causes abdominal pain by the torsion of tumor pedicle. Therefore, this type of lipoma should be considered a more aggressive surgery.

A giant lipoma of the parietal peritoneum: Laparoscopic excision with the parietal peritoneum preserving procedure - a case report with literature review

BACKGROUND

Lipomas are very common benign tumors of mature fatty tissue that can occur in any part of the body. However, lipomas of the parietal peritoneum are extremely rare.

CASE PRESENTATION

A 36-year-old man presented with urinary frequency for 6 months. On computerized tomography of the abdomen and pelvis, a well-defined fatty mass measuring 20 × 11 × 6.5 cm in size, was found in the lower abdominal cavity. We performed a laparoscopic parietal-peritoneum-preserving excision of the mass. The patient was discharged without complications on post-operative day 6.

CONCLUSIONS

To our knowledge, a laparoscopic excision with preservation of the parietal peritoneum for a giant parietal peritoneal lipoma has never been reported. Herein, we report a case of a giant lipoma of the parietal peritoneum successfully managed by laparoscopy.

Torsion of a Giant Antimesenteric Lipoma of the Ileum: A Rare Cause of Acute Abdominal Pain

Patient: Male, 67

Final Diagnosis: Torsion of a giant antimesenteric lipoma of the ileum

Symptoms: Acute abdomen

Medication: —

Clinical Procedure: En bloc segmental resection with end-to-end anastomosis

Specialty: Surgery

Twisting lipoma presenting as appendicitis-a rare presentation

Right iliac fossa (RIF) pain is the most common presenting complaint in the general surgical ward. Though there are several causes for the RIF pain, acute appendicitis is the first and common diagnosis. Here we present one of the rare differential diagnoses of RIF pain in a young female patient with one month history of intermittent right lower abdominal pain. Patient's symptoms and clinical findings indicated acute appendicitis, though ultrasonography didn't show any significant abnormality. Through diagnostic laparoscopy we found that there was torsion of anterior abdominal wall parietal peritoneal pedunculated lipoma located in RIF region. The clinical presentation, examination, investigation, laparoscopic findings and further management is presented in this case report.

Torsion of a lipoma of parietal peritoneum: a rare case mimicking acute appendicitis

Lipomas are found most often on the torso, neck, upper thighs, upper arms and armpits; they can also occur almost anywhere in the body. Parietal peritoneum lipoma is a rare intraoperative finding during abdominal surgery. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. So far only one case has been reported.