Acute Intestinal Infarction Due to Diffuse Jejunoileal and Mesenteric Lipomatosis in a 39-Year-Old Woman
Unusual clinical course, Challenging differential diagnosis, Management of emergency care, Rare disease
Nadejda Cojocari, Leonard David
Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania
Am J Case Rep 2020; 21:e922830
Available online: 2020-04-04
Although lipomas are common benign tumors of adipose tissue, diffuse lipomas involving the small bowel, large bowel, and mesentery are rare. Multiple non-encapsulated lipomas characterize diffuse intestinal and mesenteric lipomatosis. Intestinal lipomatosis can be asymptomatic or may result in complications such as intussusception, volvulus, intestinal obstruction, or hemorrhage due to mucosal ulceration. A rare case is presented of intestinal infarction due to diffuse segmental jejunoileal and mesenteric lipomatosis in a 39-year-old woman.
CASE REPORT: A 39-year-old woman was admitted to the emergency department with a 12-hour history of diffuse abdominal pain, nausea, vomiting, and absent bowel movements. She had a known history of intestinal lipomatosis, diagnosed two years previously on abdominal computed tomography (CT) imaging. At surgery, segmental jejunoileal and mesenteric lipomatosis was identified associated with acute intestinal infarction. She underwent ileal resection with side-to-side enterocolic anastomosis.
CONCLUSIONS: Diffuse intestinal and mesenteric lipomatosis is a rare condition that can be associated with complications. To our knowledge, this is the first reported case to present with acute small bowel infarction.
Keywords: Lipoma, Lipomatosis, Mesenteric Vascular Occlusion