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Kabawe E, Kabawe S, Albakour R, Alobied M, Ghazal A. Jejunal intussusception in an adult due to multiple lipomas: a rare case report from Syria. J Surg Case Rep 2019; 2019:rjz162. [PMID: 31139342 PMCID: PMC6532134 DOI: 10.1093/jscr/rjz162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 05/06/2019] [Indexed: 11/14/2022] Open
Abstract
Intussusception in adulthood is an uncommon medical condition. Multiple lipomas are a very rare cause of intussusception, and the jejunum is the least common location of lipoma. We report an unusual case of a 37-year-old man presented with non-specific symptoms. Computed tomography of the abdomen revealed a proximal jejunal loop distention. Laparoscopy revealed a jejunal intussusception 40 cm distal to treitz ligament. We switched to open surgery after failure of laparoscopic reduction which showed multiple lipomas as the cause of the intussusception. We resected a segment of 35 cm and reanastomosed the bowel. Three days later, the patient was discharged with uneventful recovery.
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Affiliation(s)
- Esraa Kabawe
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Sami Kabawe
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Rawan Albakour
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Majd Alobied
- Department of General Surgery, Aleppo University Hospital, Aleppo, Syria
| | - Ahmad Ghazal
- Department of General Surgery, Aleppo University Hospital, Aleppo, Syria
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3
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Li B, Chen T, Qi ZP, Yao LQ, Xu MD, Shi Q, Cai SL, Sun D, Zhou PH, Zhong YS. Efficacy and safety of endoscopic resection for small submucosal tumors originating from the muscularis propria layer in the gastric fundus. Surg Endosc 2018; 33:2553-2561. [PMID: 30478693 DOI: 10.1007/s00464-018-6549-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/15/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gastric small submucosal tumors (SMTs) are becoming increasingly common. However, the fundus of stomach is regarded as a difficult area for endoscopic resection (ER). In this study, we investigated the efficacy, safety, and long-term outcomes of ER for small SMTs of the gastric fundus in a large series of patients, research that was previously lacking. METHODS 537 consecutive patients with SMTs no more than 20 mm in diameter, occurring in the gastric fundus and originating from the muscularis propria layer, which were treated with endoscopic submucosal excavation or endoscopic full-thickness resection (EFTR) were included in this retrospective study at Zhongshan Hospital of Fudan University from January 2013 to September 2016. Clinicopathological, endoscopic, and follow-up data were collected and analyzed. RESULTS En bloc resection was achieved in 100% of patients, and complete resection was achieved for 530 (98.7%) lesions. Although the total rate of complications was 9.3%, few serious adverse events occurred in only three (0.6%) patients, including major pneumoperitoneum, major hydrothorax, and bleeding. Unlike lager tumor sizes and longer procedure times, endoscopist experience had a positive impact on decreasing the likelihood of complications. Based on statistical analysis, tumors with greater size near the cardia, which were treated by EFTR, were the significant contributors to longer operative times. A median follow-up of 32 months was available, and all patients were free from local recurrence or distant metastasis during the study period. CONCLUSIONS Although the gastric fundus presents technical difficulties, ER is effective for the resection of small gastric SMTs with a high complete resection rate and rare serious adverse events.
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Affiliation(s)
- Bing Li
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China
| | - Tao Chen
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China
| | - Zhi-Peng Qi
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China
| | - Li-Qing Yao
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China
| | - Mei-Dong Xu
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China
| | - Qiang Shi
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China
| | - Shi-Lun Cai
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China
| | - Di Sun
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China
| | - Ping-Hong Zhou
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China.
| | - Yun-Shi Zhong
- Endoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Endoscopy Research Institute of Fudan University, Shanghai, 200032, China.
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Kordzadeh A, Lorenzi B, Elias S, Khan MJK, Charalabopoulos A. Subtle presentation of jejunal lipomata with intussusception in a young adult. J Surg Case Rep 2017; 2017:rjx199. [PMID: 29423142 PMCID: PMC5798136 DOI: 10.1093/jscr/rjx199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/19/2017] [Indexed: 12/17/2022] Open
Abstract
Lipomas of gastrointestinal (GI) tract could occur at any anatomical level and represent 1–2% of all GI tumours. Amongst them, <2% are noted in jejunum and almost all in later decade of life with varied and non-specific symptoms. Their intussusception is even rarer and mostly present with full obstructive symptoms. Herein, we would like to report a successfully treated case of subtle jejunal lipomata with intussusception in an otherwise healthy a 21-year-old female.
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Affiliation(s)
- Ali Kordzadeh
- Department of Medical Sciences, Anglia Ruskin University, Cambridge, UK.,Department of General and Upper Gastrointestinal Surgery, Mid Essex Hospitals Services NHS Trust. Broomfield Hospital, CM1 7ET Essex, UK
| | - Bruno Lorenzi
- Department of General and Upper Gastrointestinal Surgery, Mid Essex Hospitals Services NHS Trust. Broomfield Hospital, CM1 7ET Essex, UK
| | - Sdarlis Elias
- Department of General and Upper Gastrointestinal Surgery, Mid Essex Hospitals Services NHS Trust. Broomfield Hospital, CM1 7ET Essex, UK
| | | | - Alexandros Charalabopoulos
- Department of General and Upper Gastrointestinal Surgery, Mid Essex Hospitals Services NHS Trust. Broomfield Hospital, CM1 7ET Essex, UK
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