腹腔内出血で発見された十二指腸平滑筋肉腫の1例

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  • A CASE OF LEIMYOSARCOMA OF THE DUODENUM CAUSING INTRAABDOMINAL BLEEDING

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Leiomyosarcomas of the duodenum are relatively rare. The common symptoms included abdominal pain, intestinal bleeding and a mass. Cases presenting with intraabdominal bleeding are very rare. We report such a case presenting with intraabdominal bleeding.<br> A 43-year-old man was admitted to the hospital because of a severe pain mainly located in the upper abdomen. Abdominal ultrasonography revealed a huge mass with moderate intraabdominal fluid. And by puncture, fluid was thought to be blood. Anemia was seen on admission but it did not get worse by blood transfusion. With further examinations, the tumor was suspected to be a duodenal mass growing extraluminally. Laparotomy was performed. The tumor with the maximum diameter of 20cm easily bled and was unable to be loosen from the antrum, duodenum and pancreas. At laparotomy, about 500ml of bloody fluid was seen in the abdomen, but no evidence of rupture of the tumor nor bleeding site on the vessels was proceived. The sourse of bleeding was still unclear.

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