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Kobayashi R, Inoue K, Hirose R, Doi T, Harusato A, Dohi O, Yoshida N, Uchiyama K, Ishikawa T, Takagi T, Yasuda H, Konishi H, Morinaga Y, Itoh Y. Obscure gastrointestinal bleeding from a large jejunal lipoma treated using an endoscopic unroofing technique with double balloon enteroscopy: a case study. Clin J Gastroenterol 2023; 16:32-38. [PMID: 36369458 DOI: 10.1007/s12328-022-01724-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 10/15/2022] [Indexed: 11/13/2022]
Abstract
Small intestinal lipomas are rare, but may cause obscure gastrointestinal bleeding. The endoscopic unroofing technique excises only the upper third of the lipoma and allows both histological confirmation and complete treatment with minimal risk of perforation. We present a rare case of obscure gastrointestinal bleeding caused by a jejunal lipoma. A 75-year-old man on antiplatelet therapy presented to our department with melena and anemia. Computed tomography revealed he had a 45-mm jejunal submucosal tumor with fat attenuation. Endoscopic resection using an endoscopic unroofing technique with double balloon enteroscopy was successfully performed. The tumor was confirmed to be a lipoma.
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Affiliation(s)
- Reo Kobayashi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Ken Inoue
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan.
| | - Ryohei Hirose
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Toshifumi Doi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Akihito Harusato
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Osamu Dohi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Naohisa Yoshida
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Kazuhiko Uchiyama
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Takeshi Ishikawa
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Tomohisa Takagi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Hiroaki Yasuda
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Hideyuki Konishi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Yukiko Morinaga
- Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshito Itoh
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kamigyo-Ku, Kyoto, 602-8566, Japan
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Kane M, Benaboud MZ, Traore S, Lokman S, Nasri S, Aichouni N, Skiker I, Kamaoui I. Gastrointestinal hemorrhage caused by small intestinal benign tumors: 2 cases report. Pan Afr Med J 2019; 33:197. [PMID: 31692688 PMCID: PMC6814334 DOI: 10.11604/pamj.2019.33.197.18584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 06/23/2019] [Indexed: 11/11/2022] Open
Abstract
Gastrointestinal bleedings caused by small intestinal tumors are rare and difficult to diagnose because they are not easy to access to the conventional endoscopy. We report two cases, one of them from proximal jejunum and the other one from ileal intestine complicated by intussusception. The two cases were admitted in the emergency department for hematochezia and melena, the diagnosis was established by enhanced helical computed tomography angiography.
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Affiliation(s)
- Mohamed Kane
- Radiology Department of Mohammed VI hospital, Oujda, Morocco
| | | | - Samba Traore
- Radiology Department of Mohammed VI hospital, Oujda, Morocco
| | - Salma Lokman
- Radiology Department of Mohammed VI hospital, Oujda, Morocco
| | - Soumia Nasri
- Radiology Department of Mohammed VI hospital, Oujda, Morocco
| | | | - Imane Skiker
- Radiology Department of Mohammed VI hospital, Oujda, Morocco
| | - Imane Kamaoui
- Radiology Department of Mohammed VI hospital, Oujda, Morocco
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Yatagai N, Ueyama H, Shibuya T, Haga K, Takahashi M, Nomura O, Sakamoto N, Osada T, Yao T, Watanabe S. Obscure gastrointestinal bleeding caused by small intestinal lipoma: a case report. J Med Case Rep 2016; 10:226. [PMID: 27520963 PMCID: PMC4983028 DOI: 10.1186/s13256-016-1014-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/24/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Small intestinal lipomas are rare, usually asymptomatic, and most commonly encountered incidentally during investigation of the gastrointestinal tract for another reason. However, they may cause obscure gastrointestinal bleeding. CASE PRESENTATION We report a case of obscure gastrointestinal bleeding due to a small intestinal lipoma. A 69-year-old Japanese man on antiplatelet therapy presented to our department with tarry stools and anemic symptoms. A small intestinal tumor was detected by capsule endoscopy and double-balloon endoscopy. After laparoscopic resection, the tumor was confirmed to be a lipoma. CONCLUSIONS Small intestinal lipomas are difficult to detect by conventional modalities, but capsule endoscopy and double-balloon endoscopy are good modalities for the diagnosis of small intestinal lipomas. Treatment of small intestinal lipomas should be selected carefully, considering the tumor size, size of stalk, administration of antithrombotic therapy, and endoscopic operability.
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Affiliation(s)
- Noboru Yatagai
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Hiroya Ueyama
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
| | - Tomoyoshi Shibuya
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Keiichi Haga
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Masahito Takahashi
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Osamu Nomura
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Naoto Sakamoto
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Taro Osada
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Takashi Yao
- Department of Human Pathology, Juntendo University, School of Medicine, Tokyo, Japan
| | - Sumio Watanabe
- Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
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