Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
症例
腸重積を合併した上行結腸脂肪腫の1例
上野 卓教池澤 和人山田 武史間宮 孝石毛 和紀設楽 佐代子佐々木 量矢松井 聡坂本 俊樹斉藤 節
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2010 年 77 巻 2 号 p. 130-131

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The occurrence of intussusception in adults is rare, with an incidence of only 5-10%, but it occurs frequently in infants, especially in the first two years of life.
We report a case of ascending colon lipoma with intussusception in a 65-year-old man who complained of right upper quadrant pain and abdominal bloating that persisted for several weeks. Abdominal CT showed a smooth mass of fat density in the transverse colon as the lead point of intussusception. Colonoscopy showed that the mass had almost obstructed the whole lumen in the transverse colon. The mass had erosions and redness on the surface, and it was hard and the cushion sign was negative. Colonoscopy showed features different from those of typical lipoma, making diagnosis before the operation difficult. However, abdominal CT indicated that the mass was lipoma. The patient underwent surgical resection. Histological examination revealed a large pedunculated mass measuring 5 × 5.5cm that consisted of mature adipose tissue, and the tumor was diagnosed as a submucosal lipoma.
In cases of a large digestive lipoma complicated with intussusception, the lipoma can be inflamed because of circulatory disturbance on the surface and the appearance may not be like lipoma. Care is therefore needed in diagnosis in such cases.
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© 2010 一般社団法人 日本消化器内視鏡学会 関東支部
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