Pelvic lipomatosis

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Since Engels1 first reported five cases of pelvic lipomatosis at least 25 cases have been reported. Pelvic lipomatosis, a term first coined by Fogg and Smyth2 in 1968, has also been reported under other titles. Essentially, it is a benign condition in which there is an abundance of fatty tissue in the perirectal and perivesical spaces in the pelvis (Fig. 1). It is important to differentiate pelvic lipomatosis from retroperitoneal fibrosis and pelvic tumors. The clinical course, treatment, and prognosis differ dramatically. In several cases, including this case, the patients had exploratory surgery. However, the disease can be diagnosed from various clinical symptoms, physical findings, and a plain abdominal film. Roentgenographic studies of the urinary tract and the colon will confirm the diagnosis.

Case report

A 62-year-old man had been treated for various medical problems for approximately 18 years. At this examination the patient complained of chronic cough, dysuria, frequency, and urgency. He also had a history of intermittent hypertension. A urogram showed the distal thirds of both ureters to be displaced medially, and the urinary bladder to be located more cephalad than expected. The bladder had a peculiar appearance with elongation in its vertical dimension (Fig. 2)

The patient’s blood pressure at the time of admission was labile and ranged as high as 240/150. An investigation into possible organic causes of hypertension was initiated. Results of tests including a renal arteriogram were normal. Examination of the colon showed tubular narrowing and elevation of the sigmoid out of the pelvis . . .



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