Distal ileal stenosing subserosal lipoma: A case report

Lipoma is the commonest soft tissue tumour and ubiquitous in distribution.The gastrointestinal tract is a rare site for this neoplasm.This 38 years old patient presented to the surgical emergency unit of the Jos University Teaching Hospital with features of intestinal obstruction which was confirmed by plain abdominal X-ray. Patient was resuscitated and had exploratory laparotomy. At surgery,a dilated,oedematous,and pale segment of ileum was seen measuring 56cm in length and 10cm short of the ileo-caecal junction, where an obstruction had occurred.The distal segment was collapsed.A limited right hemi-colectomy was done with ileocolic anastomosis.Specimen received at the Histopathology Laboratory consisted of 45cm of the ileum,the caecum,appendix,and proximal 25cm of the colon in continuity.There was stenosis affecting the distal 30cm of the ileum.The wall of the stenosed part of ileum had intramural fat at the sub-serosal locale. Histology confirmed the presence of sheets of matured adipocytes between the muscularispropria and serosa.Patient condition improved and was discharged seven days after surgery.This case is reported five months after surgery.We recommend that lipoma be at all times considered in the differential diagnosis of intestinal obstruction.Keywords: Subserosal lipoma,ileal stenosis,intestinal obstructio