Yamabuki Takumi, Suzuoki Masato, Murakami Tsuzuku, Hirano Satoshi
Department of Surgery, Hakodate Red Cross Hospital, Hakodate, Japan.
Department of Gastroenterology, Hakodate Red Cross Hospital, Hakodate, Japan.
Case Rep Gastroenterol. 2017 Sep 13;11(3):526-530. doi: 10.1159/000479313. eCollection 2017 Sep-Dec.
An unusual case of a jejunal mesenteric pseudocyst treated by laparoscopic resection is reported. A 44-year-old woman was admitted to our hospital with intermittent upper abdominal pain and diarrhea. Physical examination revealed slight periumbilical tenderness, and no masses were palpable. Contrast-enhanced computed tomography showed a 4-cm-sized nonenhancing high-density mass with a heterogeneous pattern on a proximal small bowel loop. Based on these findings, a gastrointestinal stromal tumor accompanied by hemorrhagic and cystic change, a mesenteric hematoma, or a desmoid tumor was diagnosed. Laparoscopy was performed to obtain an accurate diagnosis. Exploration of the abdominal cavity identified a 4-cm mass originating from the mesentery of the jejunum. Segmental resection of the jejunum and its mesentery, including the mass, was performed. Macroscopically, the mass appeared to be a cystic mass of the jejunal mesentery. The mass within the cyst lumen consisted of white clayish material with no specific pathology. The final pathological diagnosis was a mesenteric pseudocyst. The patient had an uneventful postoperative course.
报道了一例通过腹腔镜切除术治疗空肠系膜假性囊肿的罕见病例。一名44岁女性因间歇性上腹部疼痛和腹泻入院。体格检查发现脐周轻度压痛,未触及肿块。增强计算机断层扫描显示近端小肠袢上有一个4厘米大小的无强化高密度肿块,呈不均匀形态。基于这些发现,诊断为伴有出血和囊性变的胃肠道间质瘤、肠系膜血肿或硬纤维瘤。进行腹腔镜检查以获得准确诊断。腹腔探查发现一个起源于空肠系膜的4厘米肿块。对空肠及其系膜进行了包括肿块在内的节段性切除。肉眼可见,肿块为空肠系膜的囊性肿块。囊腔内的肿块由白色黏土样物质组成,无特殊病理改变。最终病理诊断为肠系膜假性囊肿。患者术后恢复顺利。