Victoria Nguyen Sean Sojdie Kunal Elete Justin Richardson Long Hoang
HCA Healthcare
01-01-2024
INTRODUCTION: Colonic lipomas are rare, benign non-epithelial lesions of the gastrointestinal (GI) tract that predominantly affect elderly females and often found in the ascending colon. They are leas..
INTRODUCTION: Colonic lipomas are rare, benign non-epithelial lesions of the gastrointestinal (GI) tract that predominantly affect elderly females and often found in the ascending colon. They are least common in the rectum, with a prevalence of 3.4%. Lipomas can grow to cause abdominal pain, bleeding, or obstruction. We report an incidental finding of a rectal lipoma in a patient presented with rectal bleeding. CASE: A 70 year-old male with a history of migraines presented to the hospital for two weeks of rectal bleeding and syncopal episode prior to arrival. Patient had visited the emergency department two weeks prior, but hemoglobin was 14.1 g/dL and vital signs were stable, so he was discharged home. Since then, he reported having four bowel movements daily with formed stools mixed with bright red blood. Notably, he uses two tablets of Excedrin daily for migraines. He denied dysphagia, abdominal pain, diarrhea, constipation, or melena. Labs showed a drop in hemoglobin from 14.1 to 9.3 g/dL. A CTA A/P revealed no active source of GI bleeding nor abnormal masses within the GI tract. Thus, it was decided to proceed with upper and lower endoscopies. Findings revealed H. pylori gastritis, sigmoid diverticulosis without active bleeding, and a polypoid lesion in the distal rectum with a positive pillow sign. Diagnosis was confirmed by Endoscopic ultrasound showing a rectal lipoma measuring 7 x 13 mm. No therapeutic intervention was deemed necessary. Upon discharge, rectal bleeding ceased, and hemoglobin stabilized. This case contributes to the broader understanding of this rare condition and its potential variations, ultimately aiding clinicians in making informed decisions when faced with similar cases in the future.