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Intermittent melena and refractory anemia due to jejunal cavernous lymphangioma:A case report

World Journal of Gastrointestinal Surgery 2024年第4期16卷 1208-1214页

作者： Kai-Rui Liu Sheng Zhang Wei-Run Chen You-Xing Huang Xu-Guang Li Department of Abdominal Surgery The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510000Guangdong ProvinceChina Department of General Surgery The Affiliated Brain Hospital of Guangzhou Medical UniversityGuangzhou 510000Guangdong ProvinceChina Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China Guangzhou Medical UniversityGuangzhou 510000Guangdong ProvinceChina

BACKGROUND Lymphangiomas in the gastrointestinal tract are extremely rare in adults.As a benign lesion,small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis.However,lymphangiomas can give rise to complications such as abdominal pain,bleeding,volvulus,and intussusception.Here,we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult.CASE SUMMARY A 66-year-old man presented with intermittent melena,fatigue and refractory anemia nine months prior.Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding.Conservative management,including transfusion,hemostasis,gastric acid secretion inhibition and symptomatic treatment,was performed,but the lesions tended to recur shortly after surgery.Ultimately,the patient underwent capsule endoscopy,which revealed a more than 10 cm lesion accompanied by active bleeding.After singleballoon enteroscopy and biopsy,a diagnosis of jejunal cavernous lymphangioma was confirmed,and the patient underwent surgical resection.No complications or recurrences were observed postoperatively.CONCLUSION Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding.Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis.Surgical resection is an effective management method.

关键词： Intermittent melena Refractory anemia Capsule endoscopy Single-balloon enteroscopy Jejunal cavernous lymphangioma enterectomy Case report

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Laparoscopic versus Open Resection of Small Bowel Gastrointestinal Stromal Tumors： Systematic Review and Meta-analysis

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Chinese Medical Journal 2017年第13期130卷 1595-1603页

作者： Ke Chen Bin Zhang Yue-Long Liang Lin Ji Shun-Jie Xia Yu Pan Xue-Yong Zheng Xian-Fa Wang Xiu-Jun Cai Department of General Surgery Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou Zhejiang 310016 China School of Medicine Zhejiang University Hangzhou Zhejiang 310058 China

Background： Laparoscopic resection （LAP） for small bowel gastrointestinal stromal tumors （GISTs） is not as common as for stomach. This study aimed to evaluate the safety and efficacy of LAP for small bowel GISTs with systematic review and meta-analysis. Methods： The Web of Science, Cochrane Library, Embase, and PubMed databases before December 2016 were comprehensively searched to retrieve comparative trials of LAP and conventional open resection （OPEN） for GISTs of small bowel with a relevance of review object. These researches reported intraoperative and postoperative clinical course （operation time, blood loss, time to first flatus and oral intake, hospital stay, morbidity, and mortality）, oncologic outcomes, and long-term survival status. Results： Six studies involving 391 patients were identified. Compared to （）PEN, LAP had associated with a shorter operation time （weighted mean difference [WMD] = -27.97 rain, 95% confidence interval [CI]： 49.40 -6.54, P 〈 0.01）： less intraoperative blood loss （WMD - -0.72 ml： 95% CI： 1.30--0.13, P = 0.02）; earlier time to flatus （WMD = -0.83 day; 95% C/： 1.44- 0.22, P 〈 0.01）; earlier time to restart oral intake （WMD - 1.95 days; 95% CI： -3.31 -0.60, P 〈 0.01 ）; shorter hospital stay （WMD = -3.00 days; 95% CI： -4.87 -1.13, P 〈 0.01）; and a decrease in overall complications （risk ratio = 0.56, 95% CI： 0.33-0.97, P 0.04）. In addition, the tumor recurrence and long-term survival rate showed that there was no significant difference between the two groups of patients. Conclusions： LAP for small bowel GISTs is a safe and feasible procedure with shorter operation time, less blood loss, less overall complications, and quicker recovery. Besides, tumor recurrence and the long-term survival rate are similar to open approach. Because of the limitations of this study, methodologically high-quality studies are needed for certain appraisal.

关键词： Complications enterectomy Gastrointestinal Stromal Tumor Laparoscopy Meta-analysis

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Midgut neuroendocrine tumor presenting with acute intestinal ischemia

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World Journal of Gastroenterology 2017年第45期23卷 8090-8096页

作者： Ioannis Mantzoros Natalia Antigoni Savvala Orestis Ioannidis Styliani Parpoudi Lydia Loutzidou Despoina Kyriakidou Angeliki Cheva Vasileios Intzos Konstantinos Tsalis Fourth Surgical Department Faculty of Health ScienceSchool of MedicineAristotle Uni-versity of Thessaloniki“G.Papanikolaou”General Hospital Department of Pathology General Hospital“G.Papanikolaou” Department of Radiology General Hospital“G.Papanikolaou”

Neuroendocrine tumors represent a heterogeneous group of neoplasms that arise from neuroendocrine cells and secrete various peptides and bioamines. While gastrointestinal neuroendocrine tumors,commonly called carcinoids,account for about 2/3 of all neuroendocrine tumors,they are relatively rare. Small intestine neuroendocrine tumors originate from intestinal enterochromaffin cells and represent about 1/4 of small intestine neoplasms. They can be asymptomatic or cause nonspecific symptoms,which usually leads to a delayed diagnosis. Imaging modalities can aid diagnosis and surgery remains the mainstay of treatment. We present a case of a jejunal neuroendocrine tumor that caused nonspecific symptoms for about 1 year before manifesting with acute mesenteric ischemia. Abdominal X-rays revealed pneumatosis intestinalis and an abdominal ultrasound and computed tomography confirmed the diagnosis. The patient was submitted to segmental enterectomy. Histopathological study demonstrated a neuroendocrine tumor with perineural and arterial infiltration and lymph node metastasis. The postoperative course was uneventful and the patient denied any adjuvant treatment.

关键词：小肠良性肿瘤 Enterochromaffin 房间空肠 enterectomy Pneumatosis intestinalis

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Ewing sarcoma of the jejunum: A case report and literature review

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World Journal of Gastrointestinal Surgery 2021年第5期13卷 507-515页

作者： Kamleshsingh Shadhu Dadhija Ramlagun-Mungur Xiao-Chun Ping Department of General Surgery Gastrointestinal SurgeryThe First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina Pre-registration House Officer Medical Council of MauritiusFloreal 0000Plaine WhilhemsMauritius

BACKGROUND Ewing sarcomas(ESs)are highly aggressive malignancy and are predominant in the long bones of extremities of children and young adults with a slight male predilection and rarely presents at extra skeletal locations.CASE SUMMARY A 55-year-old woman came to our hospital after finding elevated tumor biomarkers during her physical examination.Her enhanced computed tomography scan showed a jejunal mass.The patient underwent laparoscopic enterectomy.The mass was later diagnosed as ES,evidenced by fluorescence in situ hybridization whereby the GLP ES breakpoint region 1 probe was used,showing that more than 10%of the cells showed a red-green-yellow signal proving the breakpoint rearrangement of the ES breakpoint region 1 gene in chromosome 22.CONCLUSION We describe a case of localized ES at the jejunum in China based on the literature.

关键词： Ewing sarcoma Small bowel Fluorescence in situ hybridization Ewing sarcoma breakpoint region 1 gene Jejunum enterectomy Case report

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