Abstract
Abstract:Colonic lipomas are frequently small and asymptomatic. Giant colonic lipoma (GCL) is an uncommon finding at endoscopy, and ulceration with occult blood loss leading to iron deficiency anemia (IDA) is even rarer. The choice of therapeutic procedure to treat symptomatic GCLs has been controversial. We hereby report a case of an ulcerated GCL that presented with occult bleeding and IDA. IDA resolved after the GCL was removed successfully combining endoloop ligation and snare cautery technique under endoscopic ultrasound (EUS) guidance. With the advent of EUS, endoscopic resection of submucosal tumors can be performed relatively safely by providing a viable and useful alternative to surgery.
This content is limited to qualifying members.
If you have an existing account please login now to access this article or view purchase options.
Create a free account, then purchase this article to download or access it online for 24 hours.
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
References
References1. Rogy MA, Mirza D, Berlakovich G, et al. Submucous large-bowel lipomas—presentation and management. An 18-year study. Eur J Surg 1991;157:51–55.RogyMA]]MirzaD]]BerlakovichG&etal;Submucous large-bowel lipomas—presentation and management. An 18-year study.Eur J Surg199115751-552. Waltermire AJ. Lipoma of the colon with intussusception. South Med J 1977;70:611–612.WaltermireAJLipoma of the colon with intussusception.South Med J197770611-6123. Nebbia JF, Cucchi JM, Novellas S, et al. Lipomas of the right colon: report on six cases. Clin Imaging 2007;31:390–393.NebbiaJF]]CucchiJM]]NovellasS&etal;Lipomas of the right colon: report on six cases.Clin Imaging200731390-3934. Zhang H, Cong JC, Chen CS, et al. Submucous colon lipoma: a case report and review of the literature. World J Gastroenterol 2005;11:3167–3169.ZhangH]]CongJC]]ChenCS&etal;Submucous colon lipoma: a case report and review of the literature.World J Gastroenterol2005113167-31695. Jiang L, Jiang LS, Li FY, et al. Giant submucosal lipoma located in the descending colon: a case report and review of the literature. World J Gastroenterol 14;13:5664–5667.6. Martin P, Sklow B, Adler DG. Large colonic lipoma mimicking colon cancer and causing colonic intussusception. Dig Dis Sci 2008;53:2826–2827.MartinP]]SklowB]]AdlerDGLarge colonic lipoma mimicking colon cancer and causing colonic intussusception.Dig Dis Sci2008532826-28277. Kim CY, Bandres D, Tio TL, et al. Endoscopic removal of large colonic lipomas. Gastrointest Endosc 2002;55:929–931.KimCY]]BandresD]]TioTL&etal;Endoscopic removal of large colonic lipomas.Gastrointest Endosc200255929-9318. Watanabe F, Honda S, Kubota H, et al. Preoperative diagnosis of ileal lipoma by endoscopic ultrasonography probe. J Clin Gastroenterol 2000;31:245–247.WatanabeF]]HondaS]]KubotaH&etal;Preoperative diagnosis of ileal lipoma by endoscopic ultrasonography probe.J Clin Gastroenterol200031245-2479. Yu HG, Ding YM, Tan S, et al. A safe and efficient strategy for endoscopic resection of large, gastrointestinal lipoma. Surg Endosc 2007;21:265–269.YuHG]]DingYM]]TanS&etal;A safe and efficient strategy for endoscopic resection of large, gastrointestinal lipoma.Surg Endosc200721265-26910. Ghidirim G, Mishin I, Gutsu E, et al. Giant submucosal lipoma of the cecum: report of a case and review of literature. Rom J Gastroenterol 2005;14:393–396.GhidirimG]]MishinI]]GutsuE&etal;Giant submucosal lipoma of the cecum: report of a case and review of literature.Rom J Gastroenterol200514393-39611. Chiu CC, Wei PL, Huang MT, et al. Colonoscopic-assisted laparoscopic resection of a colon lipoma. J Laparoendosc Adv Surg Tech A 2006;16:37–40.ChiuCC]]WeiPL]]HuangMT&etal;Colonoscopic-assisted laparoscopic resection of a colon lipoma.J Laparoendosc Adv Surg Tech A20061637-4012. Raju GS, Gomez G. Endoloop ligation of a large colonic lipoma: a novel technique. Gastrointest Endosc 2005;62:988–990.RajuGS]]GomezGEndoloop ligation of a large colonic lipoma: a novel technique.Gastrointest Endosc200562988-99013. Okada K, Shatari T, Suzuki K, et al. Is endoscopic submucosal dissection really contraindicated for a large submucosal lipoma of the colon? Endoscopy 2008;40 (suppl 2):E227.OkadaK]]ShatariT]]SuzukiK&etal;Is endoscopic submucosal dissection really contraindicated for a large submucosal lipoma of the colon?Endoscopy200840E227