A CASE REPORT OF A BLEEDING DUODENAL GASTROINTESTINAL STROMAL TUMOR RESECTED DURING EMERGENCY LAPAROSCOPIC SURGERY

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  • 腹腔鏡下緊急手術にて切除を行った出血性十二指腸ＧＩＳＴの１例

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Abstract

A 66-year-old woman developed gastrointestinal bleeding and progressively worsening anemia. Abdominal contrast-enhanced CT scanning and upper gastrointestinal endoscopy showed gastrointestinal bleeding from a submucosal tumor, located at the lower duodenum curve which grew extraluminally. Endoscopic hemostasis was not successful. Three days after admission, the patient developed massive hematemesis, which resulted in hypovolemic shock. She had emergency surgery to resect the tumor and the bleeding site. A laparoscopic partial duodenectomy was also done. After insufflation, her arterial blood pressure increased and vital signs became sTable allowing laparoscopic surgery.<BR>She was discharged on the 16th postoperative day. On histopathology, a gastrointestinal stromal tumor was found.<BR>It is well known that elevated intraabdominal pressure lead to increased arterial blood pressure. In cases complicated by hemorrhagic shock, the establishment of a pneumoperitoneum during laparoscopic surgery has a large effect on the circulation. This effect and its uses should be studied further.

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