Nazif ERKAN, Cemil ÇALIŞKAN, Enver VARDAR, Cengiz YILMAZ, Mustafa KORKUT

Lipoma of the large intestine: A clinicopathological review of six cases

Amaç: Kolon lipomlarının semptomları genellikle sessiz bir seyir gösterir. Bu çalışmada kalın barsak lipomu olan altı olgunun klinik özellikleri, tedavileri ve takip sonuçları literatür eşliğinde sunuldu. Hastalar ve Yöntemler: Ocak 2000 ile Aralık 2006 yılları arasında kalın barsak lipomu teşhisi konulan hastalar, klinik özellikleri, teşhis yöntemleri, cerrahi tedavileri ve patolojik sonuçları açısından retrospektif olarak değerlendirildi. Bulgular: Toplam altı kalın barsak lipom olgusu (4 erkek, 2 kadın; ort. yaş 63; dağılım 43-82) ameliyat edildi. En sık bulunan semptom karın ağrısı idi. Hastaların beşi elektif olarak ameliyat edilirken, bir olgu kolokolik intussusepsiyona ikincil olarak acil şartlarda ameliyat edildi. Endoskopik biyopsilerle bir sonuca varılamadı. Ameliyat öncesi klinik tanı iki olguda kolon lipomu iken, dört olgu kolon tümörü şüphesiyle ameliyat edildi. Lipom lokalizasyonları ikişer olguda asendan ve transvers kolonda, diğer olgularda çekum ve sigmoid kolonda idi. Hastaların üçüne sağ hemikolektomi, diğer hastalara sol hemikolektomi, sigmoid ve segmenter kolon rezeksiyonları uygulandı. Cerrahi sonrası komplikasyon gelişmeyen hastalarda histopatolojik inceleme sonucu kalın barsakta submukozal lipom olarak rapor edildi. Sonuç: Büyük, semptomatik kolon lipomlarında gerek malignite kuşkusunu ekarte etmek, gerekse de barsak tıkanıklığı ve kanama gibi komplikasyonları engellemek için cerrahi tedavi gereklidir.

Kalın barsak lipomu: Altı olgunun klinikopatolojik değerlendirilmesi

Objectives: Symptoms of colonic lipomas generally have a silent clinical course. We presented the clinical features, treatment methods, and follow-up results of six cases with large bowel lipoma. Patients and Methods: A retrospective review of patients with a diagnosis of large bowel lipoma between January 2000 and December 2006 was conducted. Data related to presentation, diagnosis, surgical treatment and pathology were analyzed. Results: Six patients (4 men, 2 women; mean age 63 years; range 43 to 82 years) were operated on due to lipoma of large intestine. Abdominal pain was the most common presenting complaint. One of the patients was treated urgently due to colo-colonic intussusception and the others were operated in elective conditions. The endoscopic biopsies were inconclusive. The preoperative diagnosis was colonic lipoma in two patients and four patients were treated due to suspected tumor of the colon. The locations of the lesions were ascending and transverse colon in two patients, cecum and sigmoid colon in the others. Right hemicolectomy was performed in three patients, left hemicolectomy, sigmoid and segmenter colon resections were performed in the others. Histopathologic examinations of the resected materials showed submucosal lipoma of the large intestine. Postoperative period was uneventful in all of the patients. Conclusion: In large symptomatic colonic lipomas that can cause obstruction or hemorrhage, surgical treatment is needed to prevent complications and to exclude the possibility of malignancy.

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