Colon Lipoma
Colonic Lipoma

Video Endoscopic Sequence 1 of 3.

Video Endoscopic Image of a Colonic Lipoma

Gastrointestinal lipomas are usually smooth globular
lesions covered by normal mucosa, Lipomas are common
benign mesenchymal tumors. They may develop in virtually
all organs throughout the body. Mucosal erosion over the
lipoma may lead to severe bleeding.

Colonic Lipoma

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Video Endoscopic Image of a Colonic Lipoma

Video Endoscopic Sequence 2 of 3.

Video Endoscopic Image of a Colonic Lipoma

" The Pillow Sign".

 

Video Endoscopic Sequence 3 of 3.

After acquiring the biopsies Fat is displayed, note the small round yellowish (fat).
Removal of a portion of overlying mucosa with a biopsy
forceps revealed the underlying fatty tissue.

Colonoscopy of Ileocecal Valve Lipoma

Video Endoscopic Sequence 1 of 5.

Lipoma of Ileocecal Valve

Lipomas are the most common benign mesenchymal tumors of the gastrointestinal tract, with the colon being the most prevalent site. Intestinal lipomas are usually asymptomatic. Tumors >2 cm in diameter may occasionally cause nonspecific symptoms, including change in bowel habits, abdominal pain, or rectal bleeding, but with resection the prognosis is excellent. Herein, we describe the case of an elderly male who presented with painless hematochezia.

Colonic Lipoma

 

Colonoscopy of Ileocecal Valve Lipoma

Video Endoscopic Sequence 2 of 5.

Colonoscopy of Ileocecal Valve Lipoma

Cases of ileocecal valve lipomas have been reported in the English literature, with the majority presenting as intussusception or volvulus.

Often asymptomatic and detected incidentally at the time of colonoscopy or surgery, lipomas >2 cm in diameter may occasionally cause nonspecific symptoms, including change in bowel habits, abdominal pain, or rectal bleeding. Diagnosis of gastrointestinal lipomas may involve barium enema, colonoscopy, or computed tomography (CT). Diagnosis is notoriously difficult given that malignant disease cannot be excluded definitively through imaging or biopsy alone. A wide range of operative and nonoperative techniques has been utilized for resection. Few cases of lipoma have been reported to date with origin at the ileocecal valve, the majority of which have presented as intussusception or volvulus. We describe a rare case of an ulcerated ileocecal valve lipoma associated with lower gastrointestinal bleeding that was significant enough to require urgent endoscopy or laparoscopic resection.

 

 

Colonoscopy of Ileocecal Valve Lipoma

Video Endoscopic Sequence 3 of 5.

Colonoscopy of Ileocecal Valve Lipoma

It tries to advance the colonoscope to the terminal ileum, but the displacement exerted by the lipoma was impossible despite multiple maneuvers.

Gastrointestinal lipomas are benign lesions arising from the adipocytes within the intestinal submucosa with the first case reported by Bauer in 1757.6 With a reported incidence of 0.2% to 4.4%, lipomas are the third most common benign colonic neoplasm following hyperplastic and adenomatous polyps. Lipomas are found most commonly in the colon, with the highest frequency found in the ascending colon and cecum followed by the transverse colon, descending colon, sigmoid, and least often the rectum. Despite the propensity for colonic distribution, lipomas can occur anywhere along the alimentary tract, including the hypopharynx, stomach, small bowel, and esophagus. When confined to the colon, 90% of these lesions are localized to the submucosa; however, a few reports have suggested an origin in the subserosal plane. These tumors are more prevalent in women and are typically discovered during the fifth or sixth decade of life.

 

Colonoscopy of Ileocecal Valve Lipoma

Video Endoscopic Sequence 4 of 5.

Colonoscopy of Ileocecal Valve Lipoma

Lipomas tend to be solitary, spherical, and smooth lesions. They vary in size and can be sessile or pedunculated. Cases of multiple lesions have been reported. Lipomas are generally asymptomatic and are identified most commonly as incidental findings during colonoscopy, surgery, or autopsy. In the minority of patients who do present with symptoms, the lesions tend to be >2 cm in diameter.

Colonoscopy of Ileocecal Valve Lipoma

Video Endoscopic Sequence 5 of 5.

Colonoscopy of Ileocecal Valve Lipoma

A yellow image is observed, the fat is exposed. Corresponding to the area where biopsies were acquired.

 

 

Lipoma of the sigmoid

Video Endoscopic Sequence 1 of 4.

Lipoma of the sigmoid

Lipoma of the sigmoid

Video Endoscopic Sequence 2 of 4.

This image as well as the video clip shows the exact site of
the biopsy was taken, note the small round yellowish (fat).
Removal of a portion of overlying mucosa with a biopsy
forceps revealed the underlying fatty tissue.

 

Video Endoscopic Sequence 3 of 4.

Lipomas must be differentiated from other masses or tumors.

Video Endoscopic Sequence 1 of 4.

Histology confirmed the diagnosis of benign lipoma

Video Endoscopic Sequence 1 of 4.

Colonic Lipoma with a small hyperplastic polyp.

Yellow mass was seen in the transverse colon. Lipomas are
probably the commonest submucosal polyps occurring in
the large bowel.

 

Video Endoscopic Sequence 2 of 4.

They occur most commonly in the ileum, and they may be
single or multiple. Duodenal lipomas are mostly small but
may become pedunculated with obstruction of the lumen

Video Endoscopic Sequence 3 of 4.

" The Pillow Sign"

Lipomas are soft, and typically exhibit a "pillow sign"
where a dimple is left after compression wit the tip of the
biopsy forceps.

Lipoma. Fatty tumors can be indented with a biopsy
forceps, resulting in a cushion or pillow sign.

 

Video Endoscopic Sequence 4 of 4.

The small polyp is being removing with the biopsy forceps.

Lipoma of the sigmoid

Small submucosal mass of the sigmoid colon is observed, which exert traction with forceps biopsy swings through the submucosa. In this case endosonography give us a greater diagnostic parameter.

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