A Case of Jejunal Lipomatosis Diagnosed with Double-balloon Enteroscopy

Abstract

A 50-year-old man was referred with intermittent abdominal pain of three months’ duration. He had no remarkable family history or past medical history. Physical and laboratory examinations produced normal results. Abdominal computed tomography revealed large amounts of fatty infiltration involving the jejunum and mesentery. A barium study of the small bowel showed multiple, variably sized polypoid lesions, extending from the proximal jejunum to the distal jejunum. We used double-balloon enteroscopy to diagnose these lesions endoscopically and pathologically, via the oral route. Double-balloon enteroscopy revealed multiple, variably sized, submucosal tumors in the jejunum, with smooth yellowish surfaces. These submucosal tumors had a soft consistency, with mucosal indentation, which constitutes the socalled “cushion sign”. Histopathology showed no definite adipose tissue in the submucosal layer. However, the patient was diagnosed clinically with jejunal lipomatosis according to the results of the examinations described above, particularly the endoscopic findings. His abdominal pain was improved with conservative treatment, and the patient is currently being followed regularly in our outpatient clinic. In conclusion, this case highlights the intraluminal endoscopic characteristics of jejunal lipomatosis when double-balloon enteroscopy is used. Here, we present a case of jejunal lipomatosis diagnosed with double-balloon enteroscopy.