Symptomatic colonic lipoma: Report of two cases in Binh Dan Hospital

Abstract

Colonic lipomas are benign tumors resulting from the proliferation of mature fat cells. Gastrointestinal lipomas are rare, often asymptomatic, and most are detected through diagnostic imaging devices such as colonoscopy and abdominal-pelvic computed tomography. Lipomas of the colon were first reported by Bauer in 1757 and are most often located in the ascending colon near cecum. Approximately 90% of colonic lipomas are located in the submucosa. The remainder of these tumors is intramucosal in origin. The reported incidence of colonic lipoma ranges from 0,2% to 4,4%. These fatty tumors are rarely greater than 2 cm in size and are rarely symptomatic. Lipomas that grow more than 4 cm in size can lead to obstruction and intussusception requiring surgical or endoscopic resection. Colonic lipomas may be challenging to diagnose as they may be asymptomatic for a long time or misdiagnosed as other's conditions. Atypical etiologies of intestinal obstruction should be considered in patients with persistent intermittent abdominal discomfort. Even though benign, some abdominal tumor conditions may be presented as cases of emergency care. Symptomatic colonic lipomas can be managed by endoscopy or surgery. Polypectomy through endoscopy is the treatment choice for lipomas considered of low complication risk. These are lipomas with less than 2 cm diameter or pedunculated lipomas with a thin tail. When greater than 2 cm, surgery represents the standard therapeutic option for lipomas. In this report, we present two cases of symptomatic colonic lipomas: one case of splenic flexure lipoma and one case of lipoma in the sigmoid colon. Both cases have been noted with intestinal obstruction. Those two patients performed laparoscopic colectomy. The operation and post-operative recovery were satisfactory. Both of the patients were discharged after taking seven days of post-operative care. Through this article, we would like to introduce the incidence, clinical features, diagnostic facilities, and surgical treatment of this benign tumor.