Intestinal leiomyoma may become an indication for active intervention when symptoms develop. Obstruction or bleeding — including hematochezia — are recognised presentations that move management beyond watchful waiting.
This protocol addresses patients with a confirmed intestinal leiomyoma who present with symptoms of obstruction or bleeding. Symptomatic leiomyomas — whether causing obstructive symptoms or hematochezia — are an established indication for treatment.
An endoscopic approach is involved in the management of this scenario. The complete protocol details the specific technique, patient selection criteria, and procedural considerations.
DOI: 10.1055/a-1751-5742
Indications for treatment of SELs/NENs are: the risk of malignancy (GIST and NEN, and, very infrequently, granular cell tumor); symptoms such as obstruction or bleeding, which can be associated with leiomyomas, schwannomas, or lipomas; and lesions in specific locations in patients undergoing bariatric surgery.
All SELs originating from the mucosa, submucosa, and muscularis propria have a higher potential for an aggressive nature, which makes them unsuitable for local endoscopic excision (except for proven benign SELs such as lipomas or leiomyomas).
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