Oida Yasuhisa, Motojuku Megumi, Morikawa Goryuu, Mukai Masaya, Shimizu Kenji, Imaizumi Toshihide, Makuuchi Hiroyasu
Department of Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.
Hepatogastroenterology. 2008 Jan-Feb;55(81):146-9.
Gastrointestinal stromal tumors (GISTs) in the small intestine are relatively rare. We present a case of GIST arising from the small intestine, which could be resected under laparoscopic assistance. A 60-year-old male visited another hospital due to massive anal bleeding. Blood examination showed severe anemia. Although anemia improved after conservative treatment, the bleeding site was not identified and he was referred to our hospital for close examination. Abdominal CT showed a well-defined mass with homogeneous internal density in the left upper abdomen. On abdominal angiography, selective enhancement of the second jejunal artery revealed a tumor stain. Due to suspected GIST in the small intestine, laparoscopic-assisted resection of the jejunum was performed. Histopathological examination demonstrated low-grade malignant GIST. The laparoscopic procedure is considered to be useful as minimally invasive surgery for diagnosis and treatment of selected cases with GISTs in the small intestine.
小肠胃肠道间质瘤(GISTs)相对少见。我们报告一例起源于小肠的GIST,该病例可在腹腔镜辅助下进行切除。一名60岁男性因大量肛门出血就诊于另一家医院。血液检查显示严重贫血。尽管保守治疗后贫血有所改善,但出血部位未明确,遂转诊至我院进行进一步检查。腹部CT显示左上腹有一个边界清晰、内部密度均匀的肿块。腹部血管造影显示,空肠第二动脉的选择性强化显示有肿瘤染色。由于怀疑小肠存在GIST,遂行腹腔镜辅助空肠切除术。组织病理学检查显示为低级别恶性GIST。腹腔镜手术被认为是一种有用的微创手术,可用于诊断和治疗部分小肠GIST病例。