Giant Mesenteric Lipoma: Rare Cause of Chronic Pain Abdomen
Journal Title: Scholars Journal of Medical Case Reports - Year 2014, Vol 2, Issue 12
Abstract
Lipomas can occur anywhere in the body but origin from intestinal mesentry is very rare. Exact prevalence of lipomas is unknown because of its silent nature. Mesentric lipomas are mostly asymptomatic but sometimes associated with abdominal pain, abdominal lump and features of intestinal obstruction. A 52-yr-old man presented with abdominal pain which was on left lower abdomen and colicky in nature. Patient has history of pain abdomen since last 1yr. But it had worsened over the past 2 months. CECT scan of whole abdomen revealed a large ill defined fat density lesion noted involving mesentry on left side below the stomach extending upto suprapubic region and crossing the midline. Patient planned for open exploration. Per operative findings were: (a) an encapsulated, yellowish pink mass originating from the ileal mesentery in the lower abdominal cavity, (b) The mass extended from supra pubic region to hypogastric region and was free of any adhesions or signs of necrosis, (c) Lymphadenopathy, ascitis or fluid collection was not seen, (d) Surgical removal of the fatty mass was performed without difficulty. The resected mesenteric mass was a soft, yellow mass and 30×15×30 cm in size and weight 4.5 kg. Patient discharged on post-op day 2 and followed up in surgical outdoor for 5 month. Due to silent nature of these mesenteric lipomas, prevalence of mesenteric lipomas is unknown, but it’s certainly higher than reported. Higher incidence of Lipomas is seen in obese and diabetic people. They present as a slow-growing, non-lobulated, soft, mobile mass that does not penetrate into surrounding organs. On enlargement enough symptoms include anorexia, abdominal distension, weight loss, abdominal pain, constipation, and sensation of fullness, especially after meals. Pain abdomen is caused by pressing upon the intestinal loops when tumour is near the intestinal lumen. The size of the mesenteric lipoma in our patient was one of the largest reported in the literature. Keywords: Giant mesenteric lipoma, Intra-abdominal lipoma, CECT abdomen, Chronic pain abdomen.
Authors and Affiliations
Mittal Atul Kumar, Pandey Abhinav, Chhabra Sanjeev, Garg Prashant, Kankaria Jeevan, Jenaw Rajkamal
Keywords
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