UNASSIGNED: We report a case of lipoma that caused hematochezia in an 80-year-old woman with ischemic heart disease receiving antiplatelet therapy and on hemodialysis for renal failure. Contrast-enhanced computed tomography scans, esophagogastroduodenoscopy, and colonoscopy failed to identify the source of hematochezia. Capsule endoscopy revealed a small bowel tumor, which was removed through laparoscopic surgery without interruption of antiplatelet agents. The small bowel tumor was pathologically diagnosed as a lipoma. There was no recurrence of the hematochezia after surgery.
UNASSIGNED: Lipomas could cause hematochezia. With appropriate preoperative testing, comorbidity assessment, and surgical planning, we believe that surgical resection is a safe treatment option for the removal of small bowel lipomas even in patients who are on hemodialysis or are taking antiplatelet agents.
■我们报告一例脂肪瘤,导致缺血性心脏病80岁女性因肾衰竭接受抗血小板治疗和血液透析后出现便血。对比增强计算机断层扫描,食管胃十二指肠镜检查,结肠镜检查未能确定便血的来源。胶囊内镜显示小肠肿瘤,通过腹腔镜手术切除,不中断抗血小板药物。小肠肿瘤经病理诊断为脂肪瘤。手术后无便血复发。
■脂肪瘤可引起便血。通过适当的术前测试,合并症评估,和手术计划,我们认为,即使在血液透析或服用抗血小板药物的患者中,手术切除也是切除小肠脂肪瘤的安全治疗选择。