Laparoscopy-Assisted Jejunal Resection for Leiomyoma Preoperatively Diagnosed as Jejunal Gastrointestinal Mesenchymal Tumor by Double-Balloon Endoscopy: Report of a Case

  • SHIOI Yoshihiro
    Department of Surgery, Saiseikai Iwaizumi Hospital
  • SASAKI Akira
    Department of Surgery, Iwate Medical University School of Medicine
  • OTSUKA Kouki
    Department of Surgery, Iwate Medical University School of Medicine
  • KOEDA Keisuke
    Department of Surgery, Iwate Medical University School of Medicine
  • IKEDA Kenichiro
    Department of Surgery, Iwate Medical University School of Medicine
  • WAKABAYASHI Go
    Department of Surgery, Iwate Medical University School of Medicine

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  The advent of double–balloon endoscopy (DBE) has enhanced the precision of small–intestinal neoplasm diagnosis and enabled preoperative diagnosis. Laparoscopy–assisted surgery for small–intestinal neoplasms allows direct visualization, appropriate resection and safe anastomosis with low–invasiveness. We report a case of laparoscopy–assisted jejunal resection for jejunal gastrointestinal mesenchymal tumor (GIMT) preoperatively diagnosed by DBE. A 56–year–old woman complaining of abdominal pain and vomiting was referred to our hospital with radiographic evidence of jejunal obstruction. DBE revealed a well–defined smooth jejunal submucosal tumor. CT showed a homogeneous low–density mass of 6 cm in diameter inside and outside the jejunal lumen. Laparoscopy–assisted surgery was conducted for suspected jejunal GIMT. The tumor was found outside the jejunal lumen. A trocar incision was extended to exteriorize the jejunum, and a limited jejunal resection and anastomosis was performed. GIMT, smooth muscle type (leiomyoma), was diagnosed by histopathological and Immunohistochemical examination. Postoperative course was favorable, with no complications, and less pain than conventional surgery.

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