Title: Small Intestinal Submucosal Lipoma: A Rare Cause of Gastrointestinal Bleeding Mimicking Malignancy
Authors: Richa Chauhan, Gyanendra Singh, Upendra Prasad Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i9.66
Abstract
Small bowel tumors are rare entities that often present with nonspecific symptoms and accounts for only 2 to 6% of all the gastrointestinal cancers. The patient may remain asymptomatic or present with vague symptoms like abdominal pain, nausea, vomiting, fatigue or weakness. However, at times they can present with complications like obstruction, perforation, intussusception, severe pain, and bleeding. This bleeding may manifest as persistent melena with progressive weakness, which in an elderly person can raise the suspicion of malignancy. Because of its location, a pre-operative diagnosis and biopsy is often difficult to obtain and so, surgical intervention is always required. Here we report the case of an elderly man who presented with weakness and melena and was suspected to be a case of malignancy, but post operatively the cause was found to be asmall intestinal submucosal lipoma.
Key Words: Melena, lipoma, capsular endoscopy, malignancy.
References
- North JH, Pack MS. Malignant tumors of the small intestine: a review of 144 cases. Am Surg2000;66:46–51
- De Vita, Hellman, and Rosenberg’s. Cancer Principles and Practice of Oncology 9th edition; Lippincot Williams and Wilkins Chapter 86, pg. 2164.
- Mayo CW, Pagtalunan RJ, Brown DJ: Lipoma of the alimentary tract. Surgery 1963, 53:598-603.
- Ojha A, Zacherl J, Scheuba C, Jakesz R, Wenzl E. Primary small bowel malign-ancies: single-center results of three decades. Journal of Clinical Gastroenter-ology. 2000;30(3):289–293.
- Maglinte DD, O'Connor K, Bessette J, Chernish SM, Kelvin FM. The role of the physician in the late diagnosis of primary malignant tumors of the small intest-ine. Am J Gastroenterol 1991;86:304–8.
- Aminian A et al. Ileal intussusception secondary to both lipoma and angiolipoma: a case report. Cases J. 2009;2 (7099):1626-32.
- Ashley SW, Wells SA Jr: Tumors of the small intestine. SeminOncol 1988, 15:116-128.
- Nallamothu G, Adler DG. Review Large Colonic Lipomas. Gastroenterol Hepatol (N Y). 2011 Jul; 7(7):490-492.
- Ekberg O, Ekholm S. Radiography in primary tumors of the small bowel. Acta RadiolDiagn (Stockh). 1980;21(1):79-84.
- May A. How to Approach the Small Bowel with Flexible Enteroscopy. Gastro-enterol Clin North Am. 2010;39(4):797-806
- Cobrin GM, Pittman RH, Lewis BS. Increased diagnostic yield of small bowel tumors with capsule endoscopy. 2006;107:22–27.
- Mylonaki M, Fritscher-Ravens A, Swain P. Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding. 2003;52:1122–1126.