小腸ＧＩＳＴが誘因となった続発性小腸軸捻転症の１例

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  • A CASE OF SMALL BOWEL VOLVULUS ACCOMPANIED BY A GIST OF JEJUNUM

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An 81-year-old man presented with the abrupt onset of abdominal pain. A contrast-enhanced CT scan of the abdomen showed a “whirl sign” in the small intestine loops around the superior mesenteric artery. The patient was diagnosed as having secondary small bowel volvulus and underwent surgery. At surgery, the jejunum and ileum were twisted 360° clockwise around the superior mesenteric artery. There was no circulatory compromise in the rotated segment. A solitary tumor, about 6cm in diameter, was found in the jejunum about 110cm from the Treiz' ligament. This tumor might have caused the volvulus. We performed a wedge resection of this tumor. The histopathological diagnosis was high-grade malignant gastrointestinal stromal tumor (GIST) of small intestine.<br> GIST of the small intestine associated with small bowel volvulus is a very rare disease.

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