Khuri Safi, Gilshtein Hayim, Darawshy Abd-Alkarim, Bahouth Hany, Kluger Yoram
Department of General Surgery, Rambam Health Campus, Haifa, Israel.
Colorectal Surgery Unit, Rambam Health Campus, Haifa, Israel.
Case Rep Surg. 2017;2017:1814254. doi: 10.1155/2017/1814254. Epub 2017 Mar 28.
Gastrointestinal stromal tumor (GIST) is a rare stromal neoplasm, which represents the most common mesenchymal tumor of the gastrointestinal tract. It is characterized by indolent clinical symptoms, although it can present as a life-threatening emergency. Herein, we present two cases of primary small bowel GIST treated at our department. A 68-year-old female patient presented to our emergency department with a diffuse abdominal pain of acute onset. Imaging studies revealed a mass at proximal jejunum, with a nearby free air and fluid. At surgery, a mass of 9 cm was found at proximal jejunum, 3 cm distal to the treitz ligament, with perforation on the lateral wall of the mass. En bloc resection was performed. Pathology report was positive for gastrointestinal stromal tumor. A 70-year-old male patient presented to our emergency department with 3 days of dark tarry stool and few hours of hematochezia. Computed tomography angiography revealed a mass at the pelvis, with calcifications, attached to the distal ileum, with intraluminal blush of intravenous iodine. At surgery, a mass of 8 cm at the distal ileum was found. Resection of the mass along with a 20 cm of ileum was completed. Histopathology report was positive for malignant gastrointestinal stromal tumor.
胃肠道间质瘤（GIST）是一种罕见的间质肿瘤，是胃肠道最常见的间叶性肿瘤。其临床症状较为隐匿，不过也可能表现为危及生命的急症。在此，我们介绍两例在我科接受治疗的原发性小肠GIST病例。一名68岁女性患者因急性发作的弥漫性腹痛就诊于我院急诊科。影像学检查显示空肠近端有一肿块，附近有游离气体和液体。手术中，在空肠近端距屈氏韧带3 cm处发现一个9 cm的肿块，肿块侧壁有穿孔。进行了整块切除。病理报告显示为胃肠道间质瘤阳性。一名70岁男性患者因3天黑便及数小时便血就诊于我院急诊科。计算机断层血管造影显示盆腔有一肿块，伴有钙化，附着于回肠末端，静脉注射碘后有腔内造影剂充盈。手术中，在回肠末端发现一个8 cm的肿块。完整切除了肿块及一段20 cm的回肠。组织病理学报告显示为恶性胃肠道间质瘤阳性。
