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Revista Brasileira de Coloproctologia

Print version ISSN 0101-9880

Abstract

MARTINEZ, Carlos Augusto Real et al. Pseudolipomatosis of the colon: a case report. Rev bras. colo-proctol. [online]. 2008, vol.28, n.1, pp. 104-107. ISSN 0101-9880.  http://dx.doi.org/10.1590/S0101-98802008000100016.

Pseudolipomatosis of the colon is a rarely described benign condition that is characterized histologically by the presence of multiple vesicles containing air, in the wall of the large intestine. It is believed that this disease has iatrogenic origin, caused by air infiltration through the colon mucosa during endoscopic procedures. The objective of the present report was to present a case of pseudolipomatosis of the colon that was confirmed by histopathological studies. Case report: A 74-year-old woman underwent colonoscopy to investigate anemia. She had been complaining about cyclical rectal bleeding during evacuations, weight loss and anemia. The endoscopic examination did not show any abnormalities in the colon and only showed the presence of a single hemorrhoid, which at the time of examination presented signs of recent bleeding. Three weeks after this examination, she underwent elastic ligation of the hemorrhoid. While carrying out this procedure, a whitish yellow raised area was found in the intestinal mucosa. It was approximately 4 cm in diameter and was located on the posterior wall of the rectum at a distance of 13 cm from the anal margin. It had not existed at the time of performing the colonoscopy. The altered region of the mucosa and the elastic ligation of the hemorrhoid were biopsied. Histopathological examination showed the presence of large numbers of vacuoles of varying diameters and sometimes confluent, located in the intestinal wall layer itself. The appearance mimicked adipose tissue. The presence of a longitudinal connection allowing communication between the vacuolized region and the surface of the colon mucosa was noted. Histochemical and immunohistochemical techniques for detecting fat inside the vesicles gave negative results, thus allowing the diagnosis of pseudolipomatosis of the colon. After the elastic rubber band ligation, the patient did not present any further rectal bleeding and recovered from the anemia. Conclusion: Although pseudolipomatosis of the colon is rare, it is a condition that may be found after performing endoscopic procedures in the colon.

Keywords : Colon; Colonoscopy [adverse effects]; Lipomatosis; Endoscopy; Pseudolipomatosis.

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