Emergency pylorus-preserving pancreatoduodenectomy followed by second-stage pancreatojejunostomy for a gastrointestinal stromal tumor of the duodenum with an intratumoral gas figure: report of a case.
We report a case of a duodenal gastrointestinal stromal tumor (GIST) necessitating urgent surgery because of a gas figure on computed tomography (CT). A 46-year-old woman, complaining chiefly of upper abdominal pain and tarry stools, consulted a local doctor. A gastrointestinal fiberscopy revealed an ulcer in the second part of the duodenum, and the patient was admitted to our hospital where a dynamic CT scan showed a hypervascular solid tumor in the pancreatic head. A repeat CT scan done 4 days later showed a gas figure in the tumor, necessitating an emergency pylorus-preserving pancreatoduodenectomy (PpPD). First, we performed a tube pancreatostomy for complete external drainage of the pancreatic juice, and planned a second-stage pancreatojejunostomy for the near future. Histopathologically, the tumor was diagnosed as a GIST originating in the duodenum. The patient was discharged on postoperative day 23 after an uneventful postoperative recovery. Her local doctor completed the second-stage pancreatojejunostomy.
Department of Surgery II, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
Yoshikazu
Y
Sakakima
Soichiro
S
Inoue
Tsutomu
T
Fujii
Tsuyoshi
T
Hatsuno
Shin
S
Takeda
Tetsuya
T
Kaneko
Tetsuro
T
Nagasaka
Akimasa
A
Nakao
D014408:Biomarkers, Tumor / Q000032:analysis; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D017154:Stromal Cells; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor