Perforated gastrointestinal stromal tumor (GIST) in a true jejunal diverticulum in adulthood: report of a case.
A 61-year-old man was referred to us for investigation of acute abdominal pain. Computed tomography showed a 5.9 × 5.3 × 5.0 cm lump of food residue in the jejunum, and a large amount of free air and ascites around the liver and right paracolic gutter. He underwent emergency laparotomy for suspected peritonitis from perforation by a foreign body in the small intestine. We identified purulent exudate in the abdominal cavity and perforation of a jejunal cystic mass, attached ~40 cm from Treitz's ligament at the anti-mesenteric side of the jejunum. Based on a diagnosis of jejunal duplication with perforation, we resected that part of the small intestine and performed intra-abdominal drainage. Pathological findings confirmed the diagnosis of a perforated gastrointestinal stromal tumor (GIST) in a true jejunal diverticulum. Histopathological evidence suggests that intestinal pressure and/or hemorrhage can cause perforation in the background of a true jejunal diverticulum. To our knowledge, this is the first case report of a perforated GIST in a true jejunal diverticulum.
Department of Surgery, Hoju Memorial Hospital, 11-71 Midorigaoka, Nomi, Ishikawa, 923-1226, Japan, pignite@me.com.
Masatoshi
M
Shoji
Yutaka
Y
Yoshimitsu
Tsutomu
T
Maeda
Hiroshi
H
Sakuma
Masuo
M
Nakai
Hiroshi
H
Ueda
D013505:Digestive System Surgical Procedures; D004240:Diverticulum / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D004322:Drainage; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D007579:Jejunal Diseases / Q000209:etiology* / Q000601:surgery; D007583:Jejunum / Q000473:pathology / Q000601:surgery; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome