【英文原文在最后】13岁女性患者，既往有腹部不适病史，因急性胆汁性呕吐求医。患者自述过去数周内出现便秘、恶心、呕吐和逐渐加剧的背部疼痛等一系列症状。生命体征均在正常范围之内。查体发现弥漫性腹部压痛，无腹壁紧张，触诊发现肿块。当日进行的腹部平片可见非特异性气体征，余无明显异常。非增强CT扫描可见一19.5 cm*16.6 cm*8.8 cm的肿物，其特征符合脂肪瘤。由于该肿块无分隔且包绕周围肠道，未能排除脂肪肉瘤的可能（见图A和B）。患者接受了外科手术治疗，切除了该主要侵犯肠系膜的肿瘤，并接受了肠道吻合术。术后病理检查未能确诊，但基因测序证实为良性脂肪瘤。良性（肠道）脂肪瘤并不常见，在儿童身上出现更为罕见，但对于肥胖或有相关家族史的人群，风险可出现升高。本例中的患者并无相关家族史或风险因子。患者术后病情平稳，出院后接受随访期间未再出现相似症状。
A 13-year-old girl with a history of abdominal discomfort was admitted with an acute onset of bilious vomiting. During the preceding weeks, the patient had reported having constipation, nausea, vomiting, and abdominal and back pain of increasing intensity. The patient’s vital signs were within normal limits. The physical examination revealed diffuse abdominal tenderness without guarding and no palpable masses. Plain radiography of the abdomen that was performed earlier the same day showed a nonspecific gas pattern but was otherwise normal (Fig. S1 in the Supplementary Appendix, available with the full text of this article at NEJM.org). Computed tomography performed without the use of contrast material showed a lesion measuring 19.5 cm by 16.6 cm by 8.8 cm that had characteristics of a lipoma. Liposarcoma could not be ruled out, since the lesion contained septations and encompassed the adjacent bowel (Panels A and B, arrows). The patient underwent resection of the primarily mesenteric tumor with adjoining bowel (Panel C). Results on pathological analyses were initially inconclusive; however, genetic sequencing confirmed the diagnosis of benign lipoma. Benign lipomas occur infrequently, especially in children, although patients who are obese or who have diabetes or a family history of lipoma are at increased risk. The patient, who had no known family history or associated risk factors, was discharged after an uneventful postoperative period, with no recurrence of symptoms at follow-up.
病例来源：《新英格兰医学杂志》，由@医学专业新闻 翻译。
【英文原文在最后】13岁女性患者，既往有腹部不适病史，因急性胆汁性呕吐求医。患者自述过去数周内出现便秘、恶心、呕吐和逐渐加剧的背部疼痛等一系列症状。生命体征均在正常范围之内。查体发现弥漫性腹部压痛，无腹壁紧张，触诊发现肿块。当日进行的腹部平片可见非特异性气体征，余无明显异常。非增强CT扫描可见一19.5 cm*16.6 cm*8.8 cm的肿物，其特征符合脂肪瘤。由于该肿块无分隔且包绕周围肠道，未能排除脂肪肉瘤的可能（见图A和B）。患者接受了外科手术治疗，切除了该主要侵犯肠系膜的肿瘤，并接受了肠道吻合术。术后病理检查未能确诊，但基因测序证实为良性脂肪瘤。良性（肠道）脂肪瘤并不常见，在儿童身上出现更为罕见，但对于肥胖或有相关家族史的人群，风险可出现升高。本例中的患者并无相关家族史或风险因子。患者术后病情平稳，出院后接受随访期间未再出现相似症状。
A 13-year-old girl with a history of abdominal discomfort was admitted with an acute onset of bilious vomiting. During the preceding weeks, the patient had reported having constipation, nausea, vomiting, and abdominal and back pain of increasing intensity. The patient’s vital signs were within normal limits. The physical examination revealed diffuse abdominal tenderness without guarding and no palpable masses. Plain radiography of the abdomen that was performed earlier the same day showed a nonspecific gas pattern but was otherwise normal (Fig. S1 in the Supplementary Appendix, available with the full text of this article at NEJM.org). Computed tomography performed without the use of contrast material showed a lesion measuring 19.5 cm by 16.6 cm by 8.8 cm that had characteristics of a lipoma. Liposarcoma could not be ruled out, since the lesion contained septations and encompassed the adjacent bowel (Panels A and B, arrows). The patient underwent resection of the primarily mesenteric tumor with adjoining bowel (Panel C). Results on pathological analyses were initially inconclusive; however, genetic sequencing confirmed the diagnosis of benign lipoma. Benign lipomas occur infrequently, especially in children, although patients who are obese or who have diabetes or a family history of lipoma are at increased risk. The patient, who had no known family history or associated risk factors, was discharged after an uneventful postoperative period, with no recurrence of symptoms at follow-up.
病例来源：《新英格兰医学杂志》，由@医学专业新闻 翻译。