Characteristic appearances of colonic lipomas on barium enema: a guide to conservative management.

The double contrast barium enema appearances of seven colonic lipomas are reviewed. These lesions have submucosal features: intact mucosa, sharp margination and obtuse angles between the lesion and the adjacent colonic wall, as well as features characteristic of lipomas: pliability and shape change, broad pedicles and spherical appearances en face. They can be differentiated from the more significant colonic adenomas and then CT scanned to establish a histological diagnosis. The need for colonoscopic or surgical excision of these predominantly asymptomatic lesions occurring in elderly patients can be considerably reduced.