Rodríguez FMA, Lazos OM, Díaz PAL

Language: Spanish
References: 10
Page: 212-215
PDF size: 161.59 Kb.

ABSTRACT

Introduction: Lipohyperplasia of the ileocecal valve (LIV) is a diffuse fatty proliferation in the submucosa. Clinical summary: 76 year old woman who initiated its final suffering a month before its entrance with abdominal pain, diarrhea and bleeding of digestive tract. In the abdomen a tumor located in epigastrium and mesogastrium was felt. Computed tomography of abdomen showed compatible image with ileo-colic intussusception. She dead a day after due to hipovolemic shock. Summary of autopsy: There was an intussusception in the ileo-cecal union. In the distal end of the intussusception there was a pedunculated polipoid lesion with insertion in the valve. Microscopically the polyp was formed by diffuse abundant mature fatty tissue. There were diffuse areas of fatty weave proliferation in cecum, stomach, esophagus and rectum. Discussion: Lipohyperplasia of the ileocecal valve is more frequent between the 50 and 70 years. It has been observed that the degree of LIV is correlated with the degree of fatty infiltration of the right ventricular cavity, pancreas and the weight of the patient, our case presented lipohyperplasia of variable degree in other sites of the digestive tract such as cecum, stomach, esophagus and rectum with a normal index of corporal mass. It must be differentiated with lipoma intestinal. The clinical manifestations in most of the cases are subtle; nevertheless in those cases where the fatty tissue proliferation is important can produce pictures similar to diverticulosis, be confused with neoplasic lessions and inclusively to evolve to occlusive lessions that require urgent surgical treatment.

REFERENCES

1. Tawfik OW, McGregor DH. Lipohyperplasia of the ileocecal valve. Am J Gastroenterol 1992; 87: 82-87.

2. Haller JD, Roberts TW. Lipomas of the colon: a clinico-pathologic study of 20 cases. Surgery 1964; 55: 773-781.

3. Young TH, Ho P, Lee HS, Shyu RY, Tang HS, Hsu CT, Chao YC. A rare case of multiple intussusceptions: intense segmentary lipomatosis of the ileum. Am J Gastroenterol. 1996; 91 (1): 162-163.

4. Mylonakis BJ, Karkanias GG, Katergiannakis VA, Manouras AJ, Apostolidis NS. Lipomatosis of the ileocecal valve leading to episodes of partial small bowel obstruction. Mt Sinai J Med 1995; 62 (4): 302-304.

5. Berk RN, Davis GB, Cholhassey EB. Lipomatosis of the ileocecal valve. Am J Roentgenol Radium Ther Nucl Med. 1973; 119 (2): 323-328.

6. Boquist L, Bergdahl L, Andersson A. Lipomatosis of the ileocecal valve. Cancer. 1972; 29 (1): 136-140.

7. Deaver JM, Myers RN. Usual and unusual surgical lesions of the colon. Am J Gastroenterol 1965; 43: 449-467.

8. Woloschuk O, King Wb Jr. Lipomatosis of the ileocecal valve. Can Med Assoc J 1961; 16 (85): 701-704.

9. Moore K, Anatomía con orientación clínica, 3a ed. Madrid, España: Médica Panamericana, 1993; pp. 214.

10. Guyton y Hall, Tratado de fisiología médica. 9a ed. México: Interamericana-McGraw-Hill, 1997; pp. 879-880.