PDF(Pubmed)
Abstract：
Small intestinal lipomatosis is a rare condition that presents a diagnostic challenge due to the absence of identifiable clinical symptoms and limitations of small intestine examination methods. Consequently, preoperative diagnosis is difficult and only a limited number of cases have been documented in the scientific literature. Here, we report a rare case of volvulus caused by small intestinal lipomatosis. A 58-year-old female patient was tentatively diagnosed with acute ileus. The whirl sign was detected using abdominal three-dimensional enhanced computed tomography, along with marked local intestinal dilation and multiple irregular fat-like containing lesions. During surgery, abnormal dilation of the small intestine between 80 and 220 cm from the ileocecal valve was detected and the affected intestine displayed a folded and twisted configuration. Examination of the resected intestine showed that the inner wall of the diseased intestinal lumen was covered with more than 100 lipomas of different sizes, the largest of which measured ~8.0 cm in diameter. Based on clinical symptoms alone, it was difficult to identify the cause of intestinal volvulus before surgery. Complete resection of the affected small intestine and subsequent pathological analysis yielded a definitive diagnosis of small intestinal lipomatosis. While small intestinal lipomatosis is a rare condition, prognosis is favorable if diagnosed early and treated appropriately. The application of three-dimensional enhanced computed tomography imaging can aid in accurate diagnosis, while complete resection of the affected small intestine is crucial to improve patient prognosis.
摘要：
小肠脂肪瘤病是一种罕见的疾病，由于缺乏可识别的临床症状和小肠检查方法的局限性，因此存在诊断挑战。因此,术前诊断是困难的,只有有限数量的病例被记录在科学文献中.这里,我们报告了一例罕见的小肠脂肪瘤病引起的肠扭转。一名58岁的女性患者被初步诊断为急性肠梗阻。使用腹部三维增强计算机断层扫描检测到涡流征，伴随着明显的局部肠扩张和多个不规则的含脂肪样病变。手术期间,检测到距回盲瓣80~220cm的小肠异常扩张,受累的肠呈现折叠和扭曲的形态.切除的肠道检查显示,病变肠腔内壁上覆盖着100多个大小不同的脂肪瘤,其中最大的测量直径~8.0厘米。仅基于临床症状，手术前很难确定肠扭转的原因。受影响的小肠的完全切除和随后的病理分析得出了小肠脂肪瘤病的明确诊断。虽然小肠脂肪瘤病是一种罕见的疾病，如果早期诊断和适当治疗，预后良好。三维增强计算机断层扫描成像的应用可以帮助准确诊断，而完全切除受影响的小肠对于改善患者预后至关重要。
