M S Prashantha B Babannavar, Reddy C Karunakar, Augustine Alfred J, Sagari Shitalkumar G
Senior Resident, Department of General Surgery, Raja Rajeshwari Medical College , Bangalore, Karnataka, India .
Post Graduate Student, Department of General Surgery, Kasturba Medical College , Mangalore, Karnataka, India .
J Clin Diagn Res. 2015 Jan;9(1):PD05-6. doi: 10.7860/JCDR/2015/10457.5370. Epub 2015 Jan 1.
Gastrointestinal stromal tumours (GISTs) account for less than 3% of all gastrointestinal tract tumours and 5.7% of all sarcomas, and the majority of these tumours are gastric in origin. Patients commonly present with gastrointestinal bleeding or abdominal pain with 10-30% of patients presenting with symptoms of gastrointestinal obstruction. We report a rare case clinically presenting as gastric outlet obstruction, gastroscopy suspecting it to be organo-axial gastric volvulus, CECT(Contrast Enhanced Computerised Tomography) suggesting features of gastric malignancy (leiomyosarcoma) keeping the possibility of differential diagnosis of GIST. Eventually on exploratory laparotomy we discovered gastric outlet obstruction due to transpylorically herniated pedunculated polypoid GIST leading to gastroduodenal inussusception.
胃肠道间质瘤(GISTs)占所有胃肠道肿瘤的比例不到3%,占所有肉瘤的5.7%,并且这些肿瘤大多数起源于胃。患者通常表现为胃肠道出血或腹痛,10% - 30%的患者表现为胃肠道梗阻症状。我们报告一例罕见病例,临床呈现胃出口梗阻,胃镜检查怀疑为器官轴型胃扭转,增强CT(对比增强计算机断层扫描)提示胃恶性肿瘤(平滑肌肉瘤)特征,需对GIST进行鉴别诊断。最终,在剖腹探查术中,我们发现胃出口梗阻是由于经幽门疝出的带蒂息肉样GIST导致胃十二指肠套叠。