Lipoma within Inverted Meckel's Diverticulum: A Case Report
A 33-year-old man presented with recurrent episodes of abdominal pain. He had experienced intermittent epigastric pain for about 10 months, which developed into pain of the entire abdomen for 3 months. The abdominal pain was not associated with any other symptoms and resolved spontaneously, so he did not seek medical attention. There was no significant past medical or family history. Laboratory findings on admission were unremarkable. Abdominal computed tomography revealed slightly dilated loops of small bowel and a hypo-dense, irregularly contoured polypoid mass in the ileum (). Radiological features were suggestive of intussusception. However, there was a difficulty in finding the cause of the ileo-ileal intussusception in this patient. He had no history of previous operations or malignancy and was relatively healthy. During the operation to address the intussusception, a dimple was noted in the antimesenteric ileal wall, 40 cm proximal to the ileocecal valve. Gentle reduction of the intussusception demonstrated a large polypoid mass attached to a stalk at the corresponding mucosa of the dimpled area. Segmental resection of small bowel was performed. Grossly, the resected specimen showed a large pedunculated mass (6×4×3 cm) with surface ulceration. The stalk portion was connected to adjacent mucosa. On sectioning, the mass was homogenous, soft, and yellow with some white fibrotic tissue in the stalk (). The preliminary gross diagnosis was a submucosal lipoma. Microscopic findings revealed that the mass consisted of mature fat cells with scattered pancreatic acinar and ductal cells in the periphery. The mucosa overlying the mass was gastric type epithelium and showed focal ulceration.\nThe proper muscle was obliterated. The final diagnosis was a lipoma within an inverted Meckel's diverticulum (). The patient was discharged on postoperative day 7 without any complications.