A Case of Surgery for Gastrointestinal Stromal Tumor of Small Intestine with Intraluminal Growth for which the Anatomic Bleed Site was Determined by Intraoperative Infusion of Dyes Through a Catheter Deployed During Abdominal Angiography

Ken Yanagi, Masaichi Furuya, Yasuhito Shimizu, Kazuhito Yamamoto, Koichi Bando and Takashi Tajiri*

Department of Surgery, Shimodate Municipal Hospital
Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine*

Upper and lower gastrointestinal tract endoscopy failed to find the bleeding site in a 57-year-old man with hematochezia. Abdominal angiography and CT during arteriography to assess suspected small intestinal bleeding showed intra intestinal tumor staining from the periphery of the first jejunal artery. This was diagnosed preoperatively as an intestinal tumor and laparotomy was conducted placing a micro catheter in the artery that supplied the tumor for angiography. The serous membrane at the tumor growth was identified by infusion of dyes through the catheter. Histopathological examination showed low-grade malignant gastrointestinal stromal tumor (GIST). This is, to our knowledge, the first and only case in Japan of GIST manifested with melena and intra intestinal development. This case also indicates that intraoperative infusion of dyes through a catheter during angiography is helpful in determining the anatomic region of the tumor and contributes to prompt diagnosis and treatment, even in an emergency.

Key words
gastrointestinal stromal tumor, small intestine, angiography

Reprint requests
Ken Yanagi Department of Surgery, Shimodate Municipal Hospital
1658 Tamado, Shimodate, 308-0847 JAPAN

Accepted
October 19, 2004

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