Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report

Abstract Background A leiomyosarcoma of the gastrointestinal tract is extremely rare. We report a case of jejunal leiomyosarcoma with intestinal intussusception at the angle of Treitz that was successfully treated with laparoscopic resection followed by intracorporeal reconstruction using a delta-sh...

Full description

Saved in:
Bibliographic Details
Main Authors: Kenichi Nakamura, Susumu Shibasaki, Seiji Yamada, Kazumitsu Suzuki, Akiko Serizawa, Shingo Akimoto, Masaya Nakauchi, Tsuyoshi Tanaka, Kazuki Inaba, Ichiro Uyama, Koichi Suda
Format: Article
Language:English
Published: Japan Surgical Society 2022-09-01
Series:Surgical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s40792-022-01541-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850109118002495488
author Kenichi Nakamura
Susumu Shibasaki
Seiji Yamada
Kazumitsu Suzuki
Akiko Serizawa
Shingo Akimoto
Masaya Nakauchi
Tsuyoshi Tanaka
Kazuki Inaba
Ichiro Uyama
Koichi Suda
author_facet Kenichi Nakamura
Susumu Shibasaki
Seiji Yamada
Kazumitsu Suzuki
Akiko Serizawa
Shingo Akimoto
Masaya Nakauchi
Tsuyoshi Tanaka
Kazuki Inaba
Ichiro Uyama
Koichi Suda
author_sort Kenichi Nakamura
collection DOAJ
description Abstract Background A leiomyosarcoma of the gastrointestinal tract is extremely rare. We report a case of jejunal leiomyosarcoma with intestinal intussusception at the angle of Treitz that was successfully treated with laparoscopic resection followed by intracorporeal reconstruction using a delta-shaped anastomosis. Case presentation A 54-year-old man was referred to our hospital due to fatigue and loss of appetite. Blood tests showed anemia. Enteroscopy and subsequent enterography using meglumine sodium amidotrizoate showed easily hemorrhagic tumor (10 cm in diameter) in the jejunum just beyond the angle of Treitz. Contrast-enhanced computed tomography revealed jejunojejunal intussusception. Histopathological examination of a biopsy specimen revealed a leiomyosarcoma. Laparoscopic resection of the tumor without reduction of the intussusception was performed. The resected line of the proximal intestine was very close to the ligament of Treitz in the present case. Intracorporeal jejunojejunostomy was completed using a delta-shaped anastomosis, wherein anastomosis was performed between the posterior walls of the proximal and distal jejunums after minimal mobilization around the ligament of Treitz. The patient’s postoperative course was uneventful, and he was discharged at 10 days postoperatively. No recurrence has been observed within 2 years after surgery. Conclusions We present a case in which a totally laparoscopic surgery for leiomyosarcoma located at the angle of Treitz with jejunojejunal intussusception was performed successfully.
format Article
id doaj-art-0056ca3dbb944f0084c3323b7701ca05
institution OA Journals
issn 2198-7793
language English
publishDate 2022-09-01
publisher Japan Surgical Society
record_format Article
series Surgical Case Reports
spelling doaj-art-0056ca3dbb944f0084c3323b7701ca052025-08-20T02:38:10ZengJapan Surgical SocietySurgical Case Reports2198-77932022-09-01811910.1186/s40792-022-01541-3Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case reportKenichi Nakamura0Susumu Shibasaki1Seiji Yamada2Kazumitsu Suzuki3Akiko Serizawa4Shingo Akimoto5Masaya Nakauchi6Tsuyoshi Tanaka7Kazuki Inaba8Ichiro Uyama9Koichi Suda10Department of Surgery, Fujita Health UniversityDepartment of Surgery, Fujita Health UniversityDepartment of Diagnostic Pathology, Fujita Health UniversityDepartment of Surgery, Fujita Health UniversityDepartment of Surgery, Fujita Health UniversityDepartment of Surgery, Fujita Health UniversityAdvanced Robotic and Endoscopic Surgery, Fujita Health UniversityDepartment of Surgery, Fujita Health UniversityAdvanced Robotic and Endoscopic Surgery, Fujita Health UniversityAdvanced Robotic and Endoscopic Surgery, Fujita Health UniversityDepartment of Surgery, Fujita Health UniversityAbstract Background A leiomyosarcoma of the gastrointestinal tract is extremely rare. We report a case of jejunal leiomyosarcoma with intestinal intussusception at the angle of Treitz that was successfully treated with laparoscopic resection followed by intracorporeal reconstruction using a delta-shaped anastomosis. Case presentation A 54-year-old man was referred to our hospital due to fatigue and loss of appetite. Blood tests showed anemia. Enteroscopy and subsequent enterography using meglumine sodium amidotrizoate showed easily hemorrhagic tumor (10 cm in diameter) in the jejunum just beyond the angle of Treitz. Contrast-enhanced computed tomography revealed jejunojejunal intussusception. Histopathological examination of a biopsy specimen revealed a leiomyosarcoma. Laparoscopic resection of the tumor without reduction of the intussusception was performed. The resected line of the proximal intestine was very close to the ligament of Treitz in the present case. Intracorporeal jejunojejunostomy was completed using a delta-shaped anastomosis, wherein anastomosis was performed between the posterior walls of the proximal and distal jejunums after minimal mobilization around the ligament of Treitz. The patient’s postoperative course was uneventful, and he was discharged at 10 days postoperatively. No recurrence has been observed within 2 years after surgery. Conclusions We present a case in which a totally laparoscopic surgery for leiomyosarcoma located at the angle of Treitz with jejunojejunal intussusception was performed successfully.https://doi.org/10.1186/s40792-022-01541-3Small bowel tumorLeiomyosarcomaLaparoscopic surgeryMesenchymal tumors
spellingShingle Kenichi Nakamura
Susumu Shibasaki
Seiji Yamada
Kazumitsu Suzuki
Akiko Serizawa
Shingo Akimoto
Masaya Nakauchi
Tsuyoshi Tanaka
Kazuki Inaba
Ichiro Uyama
Koichi Suda
Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report
Surgical Case Reports
Small bowel tumor
Leiomyosarcoma
Laparoscopic surgery
Mesenchymal tumors
title Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report
title_full Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report
title_fullStr Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report
title_full_unstemmed Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report
title_short Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report
title_sort totally laparoscopic resection using delta shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of treitz a case report
topic Small bowel tumor
Leiomyosarcoma
Laparoscopic surgery
Mesenchymal tumors
url https://doi.org/10.1186/s40792-022-01541-3
work_keys_str_mv AT kenichinakamura totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT susumushibasaki totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT seijiyamada totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT kazumitsusuzuki totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT akikoserizawa totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT shingoakimoto totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT masayanakauchi totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT tsuyoshitanaka totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT kazukiinaba totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT ichirouyama totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport
AT koichisuda totallylaparoscopicresectionusingdeltashapedanastomosisofjejunalleiomyosarcomawithintussusceptionattheangleoftreitzacasereport