Beltrán Marcelo A, Barría Carlos, Contreras Mario A, Wilson Christian S, Cruces Karina S
Servicio de Cirugía, Hospital de La Serena, Chile.
Rev Med Chil. 2009 Oct;137(10):1341-5.
Gastrointestinal duplications are uncommon developmental abnormalities that occur anywhere along the gastrointestinal tract. We report a 36 year-old female admitted to the emergency room due to abdominal pain. Computed abdominal tomography demonstrated small bowel loops surrounding a tubular cystic structure and peritoneal free fluid. The surgical exploration revealed multiple malignant implants covering the visceral and parietal peritoneum and infiltrating completely the omentum. At the ileal mesentery we found a tubular cystic whitish tumor measuring 12 cm of diameter and 15 cm on length. A complete resection of the tumor was not considered an option due to the extensive peritoneal dissemination. Thirty-four days after the operation the patient died. The histopathology of the cystic wall was compatible with the architecture of intestinal wall extensively infiltrated by a moderately differentiated mucinous adenocarcinoma; a mucosal lining in parts atrophic and in parts infiltrated or replaced by adenocarcinoma was observed. A well structured muscular layer was recognized, and the myenteric plexus was identified.
胃肠道重复畸形是一种罕见的发育异常，可发生于胃肠道的任何部位。我们报告一名36岁女性因腹痛入住急诊室。腹部计算机断层扫描显示小肠袢围绕着一个管状囊性结构以及腹腔游离液体。手术探查发现多个恶性种植灶覆盖脏腹膜和壁腹膜，并完全浸润大网膜。在回肠系膜处，我们发现一个直径12厘米、长15厘米的管状囊性白色肿瘤。由于广泛的腹膜播散，完整切除肿瘤未被视为一种选择。术后34天患者死亡。囊性壁的组织病理学与被中分化黏液腺癌广泛浸润的肠壁结构相符；观察到部分黏膜内衬萎缩，部分被腺癌浸润或取代。可见结构良好的肌层，并识别出肌间神经丛。
