Multiple small bowel lipomas with intussusception

Case contributed by Dr Andrew Dixon

Presentation

Intermittent abdominal pain and PR bleeding.

Patient Data

Age: 50
Gender: Male

There are multiple small bowel lipomas particularly within the terminal ileum. One lipoma measuring 2.5cm in diameter is associated with a short segment of intussusception. Proximal to this there is feculent appearing material within the small bowel which is non-dilated, in keeping with a degree of obstruction. 

Case Discussion

This patient was known to have cystic fibrosis which explains the fatty replacement of the pancreas. Also the appendix is dilated up to 14mm in diameter without adjacent inflammatory stranding. Distension of the appendix is a recognized finding in cystic fibrosis, and interestingly appendicitis is far less common in cystic fibrosis patients than in the general population (1-2% vs 7%). I am not aware of any association between cystic fibrosis and small bowel lipomas. 

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