Altmış Sekiz Kolonik Lipomlu Olgunun İncelenmesi

Abstract

Amaç: Bu çalışmada üçüncü basamak bir merkezde kolonoskopide lipom tespit edilen hastaların en sık lokalizasyon, uygulanan tedaviler ve eşlik eden endoskopi bulgularını içeren demografik ve klinik özelliklerini araştırdık.Gereç ve Yöntemler: Bu çalışma Ocak 2014-Temmuz 2017 tarihleri arasında hastanemizde kolonoskopi yapılan hastaların kayıtları retrospektif incelenerek yapılmıştır. Bu tarihler arasında 7250 hasta dosyası taranmış ve lipom tespit edilen 80 hasta bulunmuştur. Kolonoskopide klasik lipom tanımı yapılmayan veya biyopsi ile lipom tanısı konulmayan ve veri eksikliği olan 12 hasta çalışmadan çıkarıldıktan sonra 68 hasta çalışmaya dahil edilmiştir.Bulgular: Araştırma popülasyonu 29 kadın %43 ve 39 erkek %57 erkek hasta olmak üzere 68 kişiden oluştu. Hastaların ortalama yaşı 58 idi . Hastalarda toplam 76 tane lipom tespit edildi. Bir hastada üç tane lipom tespit edilirken altı hastada iki tane lipom tespit edildi. Diğer tüm hastalarda tek bir lipom vardı. Lipomların en sık görüldüğü yerler ise sırasıyla transvers kolon %32 , asendan kolon %26 , ileoçekal valv %16 ve çekum %9 idi. Lipomlara en sık eşlik eden kolonoskopik bulgu ise polipler idi % 51 . Lipom boyutu 2 cm’den büyük veya semptomatik olan altı hastaya tedavi uygulandı %9 . 2 cm’den büyük ancak semptomatik olmayan beş lipom olgusuna endoloop tedavisi uygulandı. İleus nedeniyle hastaneye başvuran ve kolonoskopide transvers kolonda 5 cm boyutunda lipom tespit edilen bir hastaya ise cerrahi rezeksiyon uygulandı.Sonuç: Kolonik lipomlar sıklıkla sağ kolonda ve tek olarak bulunan, polipler ile yakın ilişkili, çoğu zaman asemptomatik benign lezyonlarıdır

Keywords

• Kolonik lipom, Endoloop, Kolon polipleri

Analysis of Sixty-Eight Colonic Lipoma Cases

Abstract

Objective: In this study, we investigated the demographic and clinical characteristics of the patients who had lipomas detected by colonoscopy in a tertiary care center, including the most common localization, applied treatments, and associated endoscopy findings.Material and Methods: This study was carried out by retrospectively studying the records of patients undergoing colonoscopy in our hospital from January 2014 to July 2017. 7250 patient files were scanned and 80 patients with lipomas were detected. 12 patients with missing data and unproven lipomas were excluded from the study and 68 patients were included in the study.Results: The study population consisted of 68 patients 29 43% female and 39 57% male . The mean age of the patients was 58 . A total of 76 lipomas were detected. Three lipomas were detected in one patient, two lipomas were detected in six patients. All other patients had a single lipoma. The most common sites of lipomas were the transverse colon 32% , ascending colon 26% , ileocecal valve 16% and cecum 9% . The most frequently associated colonoscopic finding was polyps 51% . Six patients with a lipoma size greater than 2 cm or who were symptomatic were treated 9% . Endoloop therapy was applied to five asymptomatic lipomas larger than 2 cm. Surgical resection was performed in a patient who applied to the hospital due to ileus and had a 5 cm lipoma in the transverse colon.Conclusion: Colonic lipomas are benign lesions that are frequently single, asymptomatic, found in the right colon and associated with polyps

Keywords

• Colonic lipomas, Endoloop, Colonic polyps

References

1. Panagiotakis GI, Andreou AG, Petrakis IE, Tzardi M, Daskalogiannaki M, Chalkiadakis GE. Laparoscopic resection of a sigmoid colon lipoma in a young female patient: A case report and review of the literature. Oncol Lett 2017; 13(3):1303-6.
2. Yaman İ, Derici H, Demirpolat G. Giant colon lipoma. Ulus Cerrahi Derg 2013; 31:102-4.
3. Vecchio R, Ferrara M, Mosca F, Ignoto A, Latteri F. Lipomas of the large bowel. Eur J Surg 1996; 162:915-9.
4. Katsinelos P, Chatzimavroudis G, Zavos C, Pilpilidis I, Lazaraki G, Papaziogas B, Paroutoglou G, Kountouras J, Paikos D. Cecal lipoma with pseudomalignant features: A case report and review of the literature. World J Gastroenterol 2007; 13:2510-3.
5. Atmatzidis S, Chatzimavroudis G, Patsas A, Papaziogas B, Kapoulas S, Kalaitzis S, Ananiadis A, Makris J, Atmatzidis K. Pedunculated cecal lipoma causing colo- colonic intussusception: A rare case report. Case Rep Surg 2012; 2012:279213.
6. Krishnan SJ, Shehab TM, Strasius SR. Giant colonic lipoma presenting as intermittent obstruction. Clin Gastroenterol Hepatol 2006; 4(3):25.
7. Liessi G, Pavanello M, Cesari S, Dell’Antonio C, Avventi P. Large lipomas of the colon: CT and MR findings in three symptomatic cases. Abdom Imaging 1996; 21:150- 2.
8. Leufkens AM, Kwee TC, van den Bosch MA, Mali WP, Takahara T, Siersema PD. Diffusion-weighted MRI for the detection of colorectal polyps: Feasibility study. Magn Reson Imaging 2013; 31:28-35.

9. Kuzmich S, Harvey CJ, Kuzmich T, Tan KL. Ultrasound detection of colonic polyps: Perspective. Br J Radiol 2012; 85:e1155-e1164.
10. Messer J, Waye JD. The diagnosis of colonic lipomas-the naked fat sign. Gastrointest Endosc 1982; 28:186-8.
11. Kim CY, Bandres D, Tio TL, Benjamin SB, Al-Kawas FH. Endoscopic removal of large colonic lipomas. Gastrointest Endosc 2002; 55(7):929-31.
12. Murray MA, Kwan V, Williams SJ, Bourke MJ. Detachable nylon loop assisted removal of large clinically significant colonic lipomas. Gastrointest Endosc 2005; 61:756-9.
13. Zarrin-Khameh N, Haas EM, Ro J, Thrall MJ. Lipomatosis coli, a mimicker of familial polyposis. Ann Diagn Pathol 2013; 17(2):210-3.
14. Brevet M, Chatelain D, Bartoli E, Geslin G, Delcenserie R, Braillon A, Sevestre H, Dupas JL. Colonic pseudolipomatosis: clinical, endoscopical and pathological features in nine cases. Gastroenterol Clin Biol 2006; 30(1):9-13.
15. Gys B, Haenen F, Gys T. Ileocolic intussusception caused by a giant ulcerating lipoma of bauhin’s valve: An unusual cause of intestinal obstruction in the adult. Indian J Surg 2015; 77Suppl 1:1-2.
16. Zare-Khormizi MR, Moghimi M, Pourrajab F. Giant pedunculated polypoid submucosal lipoma of the splenic flexure of colon: Case report and review of the literature. Pathologica 2014; 106(2):77-81.
17. Raju GS, Gomez G. Endoloop ligation of a large colonic lipoma: A novel technique. Gastrointest Endosc 2005; 62(6):988-90.
18. Noda H, Ogasawara N, Tamura Y, Kondo Y, Izawa S, Ebi M, Funaki Y, Sasaki M, Kasugai K. Successful endoscopic submucosal dissection of a large terminal ileal lipoma. Case Rep Gastroenterol 2016; 10(3):506-11.
19. de Figueiredo LO, Garcia DP, Alberti LR, Paiva RA, Petroianu A, Paolucci LB, Costa MR. Colo-colonic intussusception due to large submucous lipoma: A case report. Int J Surg Case Rep 2016; 28:107-10.