ЛИПОМА КАК СЛУЧАЙНАЯ НАХОДКА В АБДОМИНАЛЬНОЙ ХИРУРГИИ

Abstract

Primary neoplasms of the abdominal cavity are rare and usually have a mesenchymal origin. Lipoma is a benign mature tumor of adipose tissue, it occurs more often in women aged 30 to 50 years. Retroperitoneal lipoma is a rare variant of lipoma, manifested by various signs and symptoms that can mislead specialists. Lipomas are more common in abdominal surgery in the gastrointestinal tract. In this localization, the main pathognomonic complication is intestinal intussusception. Diagnosis is difficult, due to the relatively slow growth of education, characteristic clinical manifestations may be absent for a long time. X-ray imaging is the preferred diagnostic method. To date, surgical resection is the priority method of treatment of this pathology. The analysis of scientific literature on the occurrence of abdominal lipomas is carried out. The diagnostic significance in assessing the condition and complications of lipomas has been studied. Clinical cases from personal practice on the basis of the State Clinical Hospital named after him are presented. Yudina. Patients with diagnoses of giant retroperitoneal lipoma and complicated small intestine lipoma by female intussusception aged 62 and 78 years, respectively. The first clinical case demonstrates the randomness of the determination of lipoma in a patient admitted to the clinic with a closed craniocerebral injury and a wound of the soft tissues of the head. Ultrasound of the abdominal cavity showed the presence of a large retroperitoneal formation of an inhomogeneous consistency. During laparotomy, a giant fatty tumor with clear boundaries was revealed, closely adjacent to the adipose tissue of the retroperitoneal space. Lipoma was removed, drainage of the abdominal cavity and retroperitoneal space was performed. Histopathological examination confirmed the diagnosis of retroperitoneal lipoma. The weight of the lipoma was 10.610 kg. The postoperative period proceeded without complications. The second clinical case shows how a long-term undiagnosed lipoma of the gastrointestinal tract leads to a complicated course, namely intussusception. Patient A. 78 years old with discomfort and abdominal pain during the last few weeks, small intestine invagination was detected using ultrasound. Diagnosis upon admission: acute pancreatitis. A resection of the altered section of the small intestine was performed. The postoperative period was favorable. The patient was discharged on the 10th day. The presented clinical cases of this disease once again confirm the importance of timely dispensary diagnosis of abdominal tumors.