Learning Radiology xray montage

Small Bowel Lipoma

General Considerations

  • Small bowel tumors are relatively rare, accounting for only 2% of all GI malignancies
  • Most lipomas of the GI tract occur in the colon, the small bowel being the 2nd most common site and accounting for about 25%
  • Usually solitary but may be multiple
  • Most small bowel lipomas are found in the ileum
  • Most often submucosal and may be pedunculated

Clinical Findings

  • If small, usually no symptoms
  • When symptoms occur, they are non-specific and may include
    • Abdominal pain
    • Constipation
    • Diarrhea
    • Nausea and vomiting
    • GI hemorrhage (may be occult), especially when over 2 cm
    • Obstruction (in up to 30% of symptomatic patients)
    • Lead point of intussusception

Imaging Findings

  • Conventional radiographs will be normal except when there is obstruction of the bowel
  • CT will show a low density mass in the wall of the small bowel
    • Homogeneous mass with Hounsfield units between −80 and –120
  • Upper GI series may show a submucosal mass with obtuse borders that may have barium collections in central ulcerations
  • The Lipoma may be noted to change its shape on different views owing to its pliability

Differential Diagnosis

  • Adenomas
  • Carcinoid tumor
  • Intestinal polyposis syndromes


  • If symptomatic, they may be surgically removed

Small Bowel Lipoma

Lipoma of Small Bowel. The white arrow points to sharply marginated filling defect in the distal small bowel. The mass measures -71 Hounsfield units, consistent with fat density.
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Imaging and Findings of Lipomas of the Gastrointestinal Tract. WM Thompson .AJR:184, April 2005