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Colonoscopy-assisted laparoscopic wedge resection for a large symptomatic colonic lipoma
  1. Julia Hanevelt1,
  2. Wouter Hugo de Vos Tot Nederveen Cappel1,
  3. Fiebo Johannes Cornelis ten Kate2 and
  4. Henderik Leendert van Westreenen3
  1. 1Gastroenterology and Hepatology, Isala, Zwolle, Netherlands
  2. 2Pathology, Isala, Zwolle, Netherlands
  3. 3Surgery, Isala, Zwolle, Netherlands
  1. Correspondence to Julia Hanevelt; j.hanevelt{at}isala.nl

Abstract

A colonic lipoma is an uncommon lesion that is linked with clinical symptoms in only a small portion of patients. Patients with large lipomas are often referred for major surgery, which is associated with significant morbidity and mortality. In this case, we described a female patient with recurrent episodes of gastrointestinal blood loss, abdominal pain and colocolic intussusceptions due to a large, lumen-filling, obstructive lipoma in the splenic flexure. On abdominal CT, a lesion of 3.6 cm was visualised with a fat-like density without solid components. Considering its benign nature, we intended to preserve the colon by deroofing the upper part of the lesion and then performing a colonoscopy-assisted laparoscopic wedge resection. During reassessment, auto-amputation of part of the lesion was observed, most likely as a result of long-lasting mechanical effects, which made it possible to perform solely a wedge resection with an excellent outcome.

  • Gastrointestinal surgery
  • Gastroenterology
  • Endoscopy
  • GI bleeding

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Footnotes

  • Contributors JH, WdVtNC, FJCtK were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. WdVtNC, HLvW gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.