| Journal: | Revista da Associacao Medica Brasileira |
| Database: | PERIÓDICA |
| System number: | 000307326 |
| ISSN: | 0104-4230 |
| Authors: | Bromberg, S.H1 Zampieri, J.C Cavalcanti, L.A.F Waisberg, J Barreto, E De Godoy, A.C |
| Institutions: | 1Hospital do Servidor Publico Estadual "Francisco Morato de Oliveira", Servicos de Gastroenterologia Cirurgica e Anatomia Patologica, Sao Paulo. Brasil |
| Year: | 1997 |
| Season: | Oct-Dic |
| Volumen: | 43 |
| Number: | 4 |
| Pages: | 319-325 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Artículo |
| Approach: | Caso clínico, descriptivo |
| English abstract | OBJECT. To evaluate the incidence of colorectal lipomas, its diagnostic methodology and therapeutic management. CAUISTIC AND METHODS. The reviewed necropsies performed in a six years period and the patients' records from colorectal lipomas cases treated up to 1965 until 1993 were studied enhancing the clinical presentation, their diagnosis and therapy. The 29 cases of submucosal intestinal lipomas were disposed in three groups. The first group with ten patients lipomas were detected at necropsies. The second group with 11 symptomatic patients and group three with 8 asymptomatic patients which lipomas were discovered accidentally in surgical specimes resected due to neoplasm or in the course of diagnostical procedure. RESULTS. 0.56% of patients who were submitted to necropsy disclosed colorectal lipomas situated preferentially in right colon and in female. Enterourhage was the most often symptom (54.5%) in the group two, followed by cramp abdominal pain. Intussusception appeared in three patients (27.3%). Contrary to the medical literature, the simptomatic lipomas were preferentially situated in left colon and its mean size was 6.1cm. The diagnosis were performed through opaque enema and more recently by colofibroscopy and CT scan. Resections were performed in all patients: five were enlarged, three were local and other three were endoscopic resections. Multiple lipomas were detected in 30% of patients who were submitted to necropsy and in 25% of asymptomatic group. In both groups no tumor was larger than 2.0cm of diameter. CONCLUSIONS. Colorectal lipomas are rare in both clinical presentation and necropsy. Before the advent of CT scan and colofibroscopy the majority of the patients were submitted to wide resections, in the assumption of malignancy. Afterwards the endoscopic polipectomy and local resection became our preferential management |
| Portuguese abstract | OBJETIVO. Avaliar a ocorrência de lipomas colorretais, métodos diagnósticos e conduta terapêutica, com o intuito de estabelecer normas no atendimento dos portadores desta afecção. CASUÍSTICA E MÉTODOS. Revisadas autópsias feitas em período de 6 anos e estudados os prontuários de portadores de lipomas colorretais tratados entre 1965 e 1993, com ênfase ao quadro clínico, conduta diagnóstica e terapêutica. Os 29 portadores de lipomas intestinais submucosos foram distribuídos em três grupos. O grupo I, cujos lipomas foram detetados em necrópsias; o grupo II, com doentes sintomáticos, e um terceiro grupo de enfermos assintomáticos, com lipomas encontrados acidentalmente em peças cirúrgicas ressecadas por neoplasias ou durante procedimentos diagnósticos. RESULTADOS. 0,6% dos autopsiados apresentaram lipomas colorretais, situados, preferencialmente, no cólon direito, predominando em mulheres (70,0%). No grupo II, a enterorragia foi o sintoma mais freqüente (54,5%), seguida pela dor abdominal em cólica e por alterações do hábito intestinal. A intussuscepção ocorreu em três doentes (27,3%). Ao contrário da literatura, os lipomas sintomáticos localizaram-se, preferencialmente, no cólon esquerdo, sendo seu tamanho médio de 6,1cm. Os diagnósticos foram realizados por meio do enema opaco e, mais recentemente, pela colofibroscopia e tomografia computadorizada. Neste grupo, foram realizadas ressecções em dez doentes, sendo cinco amplas, três locais e duas endoscópicas. Um paciente eliminou, espontaneamente, seu lipoma. Lipomas múltiplos foram det |
| Disciplines: | Medicina |
| Keyword: | Cirugía, Diagnóstico, Gastroenterología, Brasil, Colon, Recto, Lipomas colorectales, Lipomas submucosos de colon, Tratamiento, Colorectal lipomas |
| Keyword: | Medicine, Diagnosis, Gastroenterology, Surgery, Brazil, Colon, Rectum, Submucous colonic lipomas, Treatment |
| Full text: | Texto completo (Ver HTML) |
