Deviced Reconstruction after Segmental Resection of the Duodenum for Leiomyoma of the Duodenum

Amane Kanazawa, Takashi Oshima, Naoto Yamamoto, Tsutomu Sato, Ryo Takagawa, Hirochika Makino, Yasuhiko Nagano, Shouichi Fujii, Toshio Imada* and Chikara Kunisaki

Department of Surgery, Gastroenterological Center, Yokohama City University
Yokohama City University*

A 52-year-old woman admitted for a pancreas head tumor detected by abdominal computed tomography was further found in gastrointestinal endoscopy to have a submucosal tumor 4 cm in diameter 2.5 cm distal and on the same side of the papilla of vater of the duodenum. Endoscopic ultrasonography showed a submucosal tumor deriving from the duodenal wall muscle layer. Based on a diagnosis of duodenal GIMT and unable to rule out the possibility of malignancy, we conducted segmental duodenectomy, reestablishing gastrointestinal continuity by creating a Roux-en-Y loop of the jejunum through the retrocolic route and side-to-side duodenojejunostomy and jejunojejunostomy. Histological examination indicated leiomyoma. The postoperative course was uneventful, and an upper gastrointestinal imaging series showed smooth passage of contrast medium through the duodenojejunal route. We review reports of duodenal wedge resection for GIMT opposite the papilla of vater. Segmental duodenal resection for GIMT at the same side of the papilla of vater is rare.

Key words
leiomyoma of the duodenum, GIMT (gastrointestinal mesenchymal tumor), segmental duodenectomy

Reprint requests
Amane Kanazawa Kanagawa Department of Gastroenterological Surgery, Cancer Center
1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815 JAPAN

Accepted
December 17, 2008

To read the PDF file you will need Abobe Reader installed on your computer.