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Gossypiboma mimicking gastrointestinal stromal tumor causing intestinal obstruction: a case report.

Kawamura Y, Ogasawara N, Yamamoto S, Sasaki M, Kawamura N, Izawa S, Kobayashi Y, Kamei S, Miyachi M, Kasugai K - Case Rep Gastroenterol (2012)

Bottom Line: The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine.The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine.If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.

ABSTRACT
A 41-year-old woman was admitted to our hospital with abdominal pain that developed about 1 year after a Cesarean section. Pelvic computed tomography (CT) revealed diffuse dilation of the small intestine with fluid shadows and a pelvic tumor 55 mm in diameter. The density of the tumor, which was not enhanced by intravenous contrast medium, was diffuse and similar to that of muscular tissue, whereas the density of a capsule surrounding the mass was relatively high. T1- and T2-weighted pelvic magnetic resonance imaging (MRI) of the tumor revealed the same diffuse low-intensity signals as muscular tissue, and diffuse high-intensity signals, respectively. The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine. As inserting an ileus tube did not improve her symptoms, the patient was scheduled for tumor resection. The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine. The macroscopic findings revealed that the tumor consisted of layers of stratified gauze surrounded by a thick granulomatous wall. The gossypiboma was considered to have originated from gauze that had been left behind after the Cesarean section. If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.

No MeSH data available.


Related in: MedlinePlus

Pelvic MRI findings. a T1-weighted MRI shows the tumor with surrounding capsule with same diffuse low-intensity signals as muscular tissue. b T2-weighted MRI shows diffuse high-intensity signals and irregular wall with low-intensity signals like muscular tissue.
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Figure 2: Pelvic MRI findings. a T1-weighted MRI shows the tumor with surrounding capsule with same diffuse low-intensity signals as muscular tissue. b T2-weighted MRI shows diffuse high-intensity signals and irregular wall with low-intensity signals like muscular tissue.

Mentions: The patient underwent abdominal and pelvic MRI examinations to obtain more information about the tumor (fig. 2). T1-weighted MRI revealed the same diffuse low-intensity signals in the tumor as in the muscular tissue (fig. 2a), and T2-weighted MRI revealed diffuse high-intensity signals indicating diffuse tumor necrosis as well as an irregular wall with low-intensity signals like muscular tissue (fig. 2b). The CT and MRI findings indicated a diagnosis of GIST with diffuse necrosis and the likelihood that mechanical ileus had caused the tumor. An ileus tube was inserted into the small intestine through the patient's nose to improve the ileus. However, an abdominal X-ray showed that the ileus did not improve and her symptoms persisted. Therefore, she underwent surgery to release the ileus and to resect the tumor 4 days after admission.


Gossypiboma mimicking gastrointestinal stromal tumor causing intestinal obstruction: a case report.

Kawamura Y, Ogasawara N, Yamamoto S, Sasaki M, Kawamura N, Izawa S, Kobayashi Y, Kamei S, Miyachi M, Kasugai K - Case Rep Gastroenterol (2012)

Pelvic MRI findings. a T1-weighted MRI shows the tumor with surrounding capsule with same diffuse low-intensity signals as muscular tissue. b T2-weighted MRI shows diffuse high-intensity signals and irregular wall with low-intensity signals like muscular tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3369411&req=5

Figure 2: Pelvic MRI findings. a T1-weighted MRI shows the tumor with surrounding capsule with same diffuse low-intensity signals as muscular tissue. b T2-weighted MRI shows diffuse high-intensity signals and irregular wall with low-intensity signals like muscular tissue.
Mentions: The patient underwent abdominal and pelvic MRI examinations to obtain more information about the tumor (fig. 2). T1-weighted MRI revealed the same diffuse low-intensity signals in the tumor as in the muscular tissue (fig. 2a), and T2-weighted MRI revealed diffuse high-intensity signals indicating diffuse tumor necrosis as well as an irregular wall with low-intensity signals like muscular tissue (fig. 2b). The CT and MRI findings indicated a diagnosis of GIST with diffuse necrosis and the likelihood that mechanical ileus had caused the tumor. An ileus tube was inserted into the small intestine through the patient's nose to improve the ileus. However, an abdominal X-ray showed that the ileus did not improve and her symptoms persisted. Therefore, she underwent surgery to release the ileus and to resect the tumor 4 days after admission.

Bottom Line: The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine.The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine.If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.

ABSTRACT
A 41-year-old woman was admitted to our hospital with abdominal pain that developed about 1 year after a Cesarean section. Pelvic computed tomography (CT) revealed diffuse dilation of the small intestine with fluid shadows and a pelvic tumor 55 mm in diameter. The density of the tumor, which was not enhanced by intravenous contrast medium, was diffuse and similar to that of muscular tissue, whereas the density of a capsule surrounding the mass was relatively high. T1- and T2-weighted pelvic magnetic resonance imaging (MRI) of the tumor revealed the same diffuse low-intensity signals as muscular tissue, and diffuse high-intensity signals, respectively. The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine. As inserting an ileus tube did not improve her symptoms, the patient was scheduled for tumor resection. The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine. The macroscopic findings revealed that the tumor consisted of layers of stratified gauze surrounded by a thick granulomatous wall. The gossypiboma was considered to have originated from gauze that had been left behind after the Cesarean section. If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.

No MeSH data available.


Related in: MedlinePlus