Jejunal Lipoma, an Uncommon Cause of Gastrointestinal Bleeding

A 46-year-old male with a past history of arterial hypertension presented with asthenia and melaena. On examination, he presented tachycardia and elevated blood pressure. His blood tests showed microcytic hypochromic anaemia (haemoglobin 6.9 g/ dL). After receiving 2 units of red blood cells, the patient underwent upper endoscopy, which was unremarkable except for gastric fundic gland polyps. Ileocolonoscopy revealed only terminal ileum nodular lymphoid hyperplasia. A capsule endoscopy was done according to the diagnosis of obscure gastrointestinal bleeding. In the 2nd tercile, after a period of 30 min of slow progression, a large polypoid ulcerated mass causing significant luminal deformation was identified (Fig. 1). Antegrade double-balloon enteroscopy was performed and, in the proximal jejunum, a large diverticulum with an ulcerated border adjacent to an ulcerated lesion suggestive of subepithelial origin with approximately 8 cm (Fig. 2) was detected. On the proximal end, a tattoo was made as a reference mark. Extensive biopsies of the ulcer borders revealed only oedema, capillary proliferation, and regenerative features. A CT scan revealed, in the proximal jejunum, a target sign with a central component compatible with adipose tissue, consistent