title: [A Case of GIST in the Small Intestine Diagnosed via CT after Repeated Melena and Removed by Laparoscopy-Assisted Surgery].
abstract: A 63-year-old man visited an emergency outpatient unit with the chief complaints of melena and lightheadedness. At the time of the visit, blood tests showed Hb of 4.3 g/dL, suggesting severe anemia, and he exhibited repeated melena, even after hospitalization. Small intestinal bleeding was suspected during endoscopic examination of the lower gastrointestinal tract, and abdominalCT examination suggested a 3.5 cm tumor-like lesion in the jejunum. He was diagnosed as having bleeding of a tumor in the small intestine and consequently underwent laparoscopic surgery. Based on intraabdominal observation, Meckel 's diverticulum was confirmed in the jejunum, 100 cm from the ileocecal region, along with a 4 cm tumor in the upper jejunum, located 50 cm from Treitz's ligament. The tumor was visually confirmed to be sarcomatoid with no direct invasion to the surrounding tissues and no disseminated node, showing favorable mobility. These lesions were exteriorized from the abdominal cavity for resection and anastomosis, and the surgery was completed with no severe complications. It was diagnosed histopathologically as a gastrointestinal stromal tumor(GIST)in the small intestine, and no postoperative adjunctive chemotherapy was administered because the case was considered low risk based on the tumor diameter and the number of mitosis events. At present, 1 year after the surgery, the patient is under follow-up observation on an outpatient basis with no findings to suggest recurrence or metastasis.
authors.affiliation: Dept. of Surgery, Nissan Tamagawa Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Notani
authors.forename: Daisuke
authors.initials: D
authors.lastname: Asano
authors.forename: Naoto
authors.initials: N
authors.lastname: Fujiwara
authors.forename: Toru
authors.initials: T
authors.lastname: Kawamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sato
authors.forename: Akira
authors.initials: A
authors.lastname: Nakashima
mesh_terms: D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007580:Jejunal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008551:Melena / Q000209:etiology*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome