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Gastroduodenal Intussusception due to Gastric Submucosal Hemangiomatosis

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= Abstract =

Gastroduodenal Intussusception due to Gastric Submucosal Hemangiomatosis

Soo-Jin-Na Choi, M.D., Sang-Young Chung, M.D., Shin-Kon Kim, M.D., Sang-Woo Jung, M.D.*

Division of Pediatric Surgery, Department of Surgery and Department of Patlwlogy*

Chonnam University Medical Sclwol, Kwangju, Korea

Gastroduodenal intussusception, an invagination of a part of the gastric wall through the pyloric canal into the duodenum is a rare condition. Gastroduodenal intussusception is caused by a mobile usually benign gastric tumor. However, gastroduodenal intussusception by gastric submucosal hemangiomatosis is not documented. We have managed a case of gastric submucosal tumor leading to gastroduodenal intussusception in 2 years and 10 months old boy. The tumor was 10 x 5 x 3 cm in size in posterior wall of gastric antrum. Laparotomy, manual reduction of the intussusception, and wedge resection of posterior gastric wall including the tumor were performed. Pathologic diagnosis was a submucosal hemangiomatosis.

Index Words: Gastroduodenal intussusception, Gastric submucosal hemanRiomatosis

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Correspondence : Soo-Jin-Na Choi. Division of Pediatric Surgery. Department of Surgery, Chonnam University Medical School. Hakdong, Dongku, Kwangju 501-757.

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Fig. 1. Simple abdomen supine view, showing over- all paucity of gas except for a small amount in the stomach.

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Fig. 2. Ultrasonography of abdomen (transverse scan of epigastric area), demonstrating a characteristic target sign with representing central echogenic mucosa surrounded by sonolucent edematous wall.

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Fig. 3. Intraoperative fmdings, revealing marked widening of the duodenum and invagination of the antrum and body of stomach into the duodenum (short arrow), and pyloric ring (long arrow).

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Fig. 4. Gastrot?my fmdings. A large pedunculated submucosal mass (10 x 5 x 3 cm) arising from the posterior wall of the antrum is shown as the leading point of intussusception.

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Fig 5. Photomicrogram of the tumor. Proliferating capillaries are arranged in nest or lobules in sub- mucosa (H&E, x 20).

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1. Hobbs WH, Cohen SE: Gastroduodenal inva-

gination due a submucous lipoma of the

stomach. Am J Surg 71:505, 1946

2. Mauthe H, Zwicky G: Gastroduodemil intus- susception. Radiology 65:86, 1965

3. Meyers MA: Gastroduodenal intussusception.

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gination, Acta Radiol 14:82-94, 1933

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수치

Fig.  2.  Ultrasonography  of  abdomen  (transverse  scan  of  epigastric  area),  demonstrating  a  characteristic  target  sign  with  representing  central  echogenic  mucosa  surrounded  by  sonolucent  edematous  wall
Fig  6.  Photomicrogram  of  the  Immunostaining  for  factor  VII-related  antigen,  showing  positive  reaction  in  endothelial  cells  (H&amp;E,  x 200)

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