Intestinal Lipomatosis for which Extent of Resection was Difficult to Determine—A Case Study—

Abstract

A 52-year-old woman visited a local physician complaining mainly of abdominal pain and vomiting in September 2013 and was referred to our hospital for suspected ileus. Computed tomography revealed multiple lipomas in the small bowel and ileocecal intussusception caused by lipomas. A detailed examination resulted in the diagnosis of intestinal lipomatosis.

Intestinal lipomatosis is a relatively rare condition, comprising primarily numerous intestinal lipomas. Surgical therapies for intestinal lipomatosis include partial, local, and ileocecal resections. In our case, the two segments that were laparoscopically resected included 1) a causative lesion in the terminal ileum identified using preoperative small bowel endoscopy and 2) a segment on the oral side where multiple lipomas were found to aggregate. However, concerns about potential reintussusception due to residual lipomas and the risk of short bowel syndrome due to bowel resection made it difficult to determine the best extent of resection. As of now (2021), residual lipomas were observed with no recurrence of ileus.