• Li-Xiao Zhang, Yong-Fei Wang, Xiao-Jie Hu, Jie Qi, and Wei Liang.
• Department of Gastrointestinal Surgery, Hebei General Hospital, Shijiazhuang, Hebei, China.
• Medicine (Baltimore). 2024 Aug 2; 103 (31): e39171e39171.

RationaleDiffuse intestinal and mesenteric lipomatosis is a rare condition characterized by the overgrowth of adipose tissue in the intestines and mesentery. This case report aims to highlight the rare occurrence of chronic abdominal distention caused by this disease and its unique invasion into the muscle layer, which has not been previously reported.Patient ConcernsA 36-year-old woman with a 7-year history of abdominal distension was admitted to our hospital's Department of Gastrointestinal Surgery.DiagnoseAbdominal and pelvic computed tomography revealed diffuse small intestinal lipomatosis.InterventionsThe patient underwent surgery. We performed an open-field ilectomy involving removal of all lipomatous intestines (250 cm).OutcomesDuring the surgery, diffuse nodular ileal and mesenteric lipomatosis was confirmed, characterized by the presence of multiple nodular lipomas within the submucosal and muscular layers. The surgical intervention involved the resection of 250 cm of the affected ileum, followed by jejunoileal anastomosis. Postoperative pathology confirmed the diagnosis, with lesions observed in both the submucosa and muscle layers. The patient showed significant improvement in symptoms, with normal intestinal function and weight gain observed over a 10-month follow-up period, and no signs of recurrence.LessonsDiffuse intestinal and mesenteric lipomatosis can lead to long-term abdominal distension. Additionally, it may be involved in the muscle layer of the intestinal wall. Surgery is the primary treatment option for symptomatic intestinal lipomatosis.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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