Bleeding gastrointestinal stromal tumor (GIST) arising from jejunal deverticulum

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  • Imai Jin
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Ichikawa Hitoshi
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Shirai Takayuki
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Ito Hiroyuki
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Nagata Junko
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Kojima Seiichiro
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Takashimizu Shinji
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Uda Shuji
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Yamamoto Soichiro
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Mukai Masaya
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Nomura Eiji
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Makuuchi Hiroyasu
    Department of Surgery, Tokai University School of Medicine Hachioji Hospital
  • Tajiri Takuma
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital
  • Watanabe Norihito
    Department of Gastroenterology, Tokai University School of Medicine Hachioji Hospital

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Other Title
  • 消化管出血が契機となった空腸真性憩室由来GISTの1例

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Abstract

A 62-year-old man presented with black stool. Laboratory data showed anemia. Contrast-enhanced computed tomography revealed a hypervascular tumor in the pelvic cavity measuring 50×60 mm in size, with air pooling in the central portion of the tumor. A small bowel series demonstrated gastrografin accumulation through the fistula on the opposite side of the mesenterium, 30 cm from the ligament of Treitz. Single-balloon endoscopy showed a low-growing elevated mucosa-like submucosal tumor, which showed a pinhole formation in the center. <br> Partial jejunectomy was performed for resection of the tumor. The solid tumor appeared to arise from the jejunum on the opposite side of the mesentrium. The pathological diagnosis was GIST, because immunohistochemical analysis showed positive staining for c-kit. Interestingly, the surface of the fistula was covered with ordinary jejunal mucosa. Based on this finding, it is considered that the GIST probably arose from a jejunal diverticulum.

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