Tenesmusun Nadir Bir Nedeni: Perirektal Lipom

Lipom vücudun herhangi bölgesinde ortaya çıkabilen, yağ dokusunun kapsüllü ve iyi huylu tümörüdür. Genelde asemptomatik, yumuşak, hareketli kitleler olarak tanımlanırlar. Perineal lipom nadir görülen bir lipom bölgesi olup; hastanın oturmasında zorluğa ve rahatsızlık hissine neden olabilmektedir. Lipom boyutu büyük ise etraf sinirlerde bası etkisi oluşturarak, zamanla deformasyon oluşturarak veya sürekli sinir uyarılması nedeni ile tenesmusa neden olabilmektedir. Çalışmamızda perianal bölgede ele gelen ve sürekli dışkılama isteği şikâyeti ile polikliniğe başvuran, muayenede perirektal alanda dev lipom tanısı konulup, lipom eksizyonu yapılan olgunun sunumu amaçlanmaktadır.

A Rare Cause of Tenesmus: Perirectal Lipoma

Lipoma is an encapsulated and benign tumor of adipose tissue that can occur in any part of the body. They are generally defined as asymptomatic, soft, mobile masses. Perineal lipoma is a rare lipoma region, it can cause difficulty and discomfort for the patient to sit. If the size of the lipoma is large, it may cause tenesmus by creating a pressure effect on the surrounding nerves, creating deformation over time or due to continuous nerve stimulation. In our study, it is aimed to present the case of a patient who applied to the clinic with the complaint of persistent desire to defecate in the perianal region and was diagnosed with a giant lipoma in the perirectal area and underwent lipoma excision.

___

  • 1. del Rey IAG, Marcano AJL, Velasco AAM, de la Plaza Llamas R, Ramia JM. Giant ischiorectal lipoma as a cause of anal pain, fecal incontinence and dyspareunia. An exceptional association. Revista Argentina de Cirugía. 2021;113(3):384-7.
  • 2. Salam GA. Lipoma excision. Am Fam Physician. 2002;65(5):901-4.
  • 3. Johnson CN, Ha AS, Chen E, Davidson D. Lipomatous Soft-tissue Tumors. J Am Acad Orthop Surg. 2018;26(22):779-88.
  • 4. Dhouha B, Maroua W, Seifeddine B, Ghofrane T, Lassaad G, Rached B, et al. [Giant pelvic lipoma mimicking a liposarcoma]. Pan Afr Med J. 2019;33:20.
  • 5. Rahman GA, Abdulkadir AY, Yusuf I. Lipomatous lesions around the shoulder: Recent experience in a Nigerian hospital. International Journal of Shoulder Surgery. 2009;3(1):13.
  • 6. Chander B, Krishna M, Thakur S, Mahajan N, Vij A, Diwakaran J. Extremely rare giant retroperitoneal fibrolipoma: a case report. J Cancer Res Ther. 2012;8(2):314-6.
  • 7. Martinez CA, Palma RT, Waisberg J. Giant retroperitoneal lipoma: a case report. Arq Gastroenterol. 2003;40(4):251-5.
  • 8. van der Byl G, Cerica A, Sala MG. Retroperitoneal lipomas: A case report. J Ultrasound. 2012;15(4):257-9.
  • 9. Weniger M, D'Haese JG, Kunz W, Pratschke S, Guba M, Werner J, et al. En-bloc resection of a giant retroperitoneal lipoma: a case report and review of the literature. BMC Res Notes. 2015;8:75.
  • 10. Cauvin A, Sullivan M, Harvey M, Thompson H. Vaginal cysts causing tenesmus in a bitch. Journal of Small Animal Practice. 1995;36(7):321-4.
  • 11. Mwenda AS. Imperforate Hymen-a rare cause of acute abdominal pain and tenesmus: case report and review of the literature. Pan African Medical Journal. 2013;15(1).
  • 12. Jergens AE. Dyschezia and tenesmus. BSAVA Manual of Canine and Feline Gastroenterology: BSAVA Library; 2005. p. 94-6.
  • 13. Dozois EJ, Malireddy KK, Sim FH, Wenger DE. Surgical approach to a large dumbbell-shaped pelvic lipoma extending through the obturator foramen. Tech Coloproctol. 2007;11(3):271-4.