ArticleInternational journal of surgery case reports2026
Pylorus-spanning diffuse gastric lipomatosis as an uncommon cause of intermittent gastric outlet obstruction: a case report.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction and importance: Gastric lipomas are uncommon; diffuse gastric lipomatosis is rarer, and pyloric involvement may cause bleeding or intermittent gastric outlet obstruction. We report a pylorus-spanning lipomatosis treated definitively by laparoscopic distal gastrectomy. Presentation of case: A 75-year-old man presented with melaena and post-prandial epigastric discomfort. Endoscopy revealed a broad-based submucosal mass at the pyloric canal intermittently prolapsing into the duodenal bulb with a small healing ulcer. computed tomography (CT) showed an 8.1 × 2.7 × 3.8 cm multiseptated fat-density mass traversing the pylorus with luminal narrowing. Positron emission tomography-CT demonstrated no abnormal hypermetabolism. Because of recurrent symptoms and trans-pyloric extension, laparoscopic distal gastrectomy with Billroth II reconstruction was performed. Histopathology confirmed diffuse lipomatosis of mature adipocytes without atypia. Recovery was uneventful; 1-month and 2-year imaging showed durable patency without recurrence. Clinical discussion: Gastric lipomatosis is rare. Treatment options include endoscopic submucosal dissection and laparoscopic-endoscopic cooperative approaches such as laparoscopic-endoscopic cooperative surgery, non-exposure endoscopic-laparoscopic cooperative surgery (NEWS), and CLEAN-NET (combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique). In pylorus-spanning diffuse lipomatosis, however, distal gastrectomy remains among the most reliable strategies for definitive symptom control. Conclusion: In symptomatic, pylorus-spanning gastric lipomatosis, laparoscopic distal gastrectomy offered dependable, durable relief of obstruction.
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