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ISSN: 2643-6760

Surgery & Case Studies: Open Access Journal

Case Report(ISSN: 2643-6760)

Mesenteric Fibromatosis Simulating a Gastrointestinal Stromal Tumor: A Rare Cause of Intestinal Obstruction

Volume 5 - Issue 1

Rasoaherinomenjanahary Fanjandrainy1, Rakotondrainibe Aurélia2, Razafindrainibe Tanjonirina3, Nomenjanahary Lalaina4, Tolotra Emmanuella Christina1, Solo Corinne5, Andriantsoa Mirana Jocya1 and Samison Luc Hervé1

  • Author Information Open or Close
    • 1Digestive surgery Unit, University Hospital - Joseph Ravoahangy Andrianavalona, Madagascar
    • 2Surgical Intensive Care Unit, University Hospital - Joseph Ravoahangy Andrianavalona, Madagascar
    • 3Adult Intensive CareUnit, University Hospital of Gynecology Obstetrics of Befelatanana, Madagascar
    • 4Anatomy Pathology Unit, University Hospital - Joseph Ravoahangy Andrianavalona, Madagascar
    • 5Surgery Unit, University Hospital - Tanambao I –Antsiranana, Madagascar

    Corresponding author:Rasoaherinomenjanahary Fanjandrainy, Digestive Surgery Unit, University Hospital - Joseph Ravoahangy Andrianavalona – Antananarivo, CHU Antananarivo 101, Madagascar

Received:May 12, 2020   Published: May 22, 2020

DOI: 10.32474/SCSOAJ.2020.05.000204

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Abstract

Mesenteric fibromatosis also known as mesenteric desmoids is a rare benign mesenchymal lesion that can occur throughout the gastrointestinal tract, especially small bowel. Because of its biological behavior, mesenteric fibromatosis is often confused with submucosal tumor or malignant neoplasm of gastrointestinal tract, mainly gastrointestinal stromal tumors (GIST). Often asymptomatic or by incidental finding, these tumors can be revealed by signs and symptoms related to the small bowel such as abdominal pain or a palpable abdominal mass ; or by clinical complications like gastrointestinal bleeding, small bowel obstruction, fistula formation, or bowel perforation. The authors report a rare case of small bowel obstruction secondary to sporadic synchronous intra-abdominal fibromatosis in a 61-years old man who complained for a palpable mass at left lower quadrant of his abdomen and which was initially misinterpreted as a GIST on the CT. A laparotomy was planed, but the patient complained for abdominal pain with a stop of flatus and stools which required emergency hospitalization. En-bloc resection of the tumor with the adjacent jejunum was performed followed by end-to-end anastomosis. Postoperative course was unremarkable. The diagnosis was revised as mesenteric fibromatosis according to pathologic examination. Bowel obstruction is a rarely revealing complication of mesenteric fibromatosis. Clinical manifestations at a complicated stage require emergency surgery in suitable candidates. In this case, emergency tumor excision made it possible to avoid complications from intestinal obstruction and to correct the first diagnosis, which was initially a GIST.

Keywords: Anastomosis, Surgical; Benign Neoplasm; Fibromatosis, Abdominal; Intestinal Obstruction; Margins of Excision; Mesentery

Abstract| Introduction| Case presentation| Discussion| Conclusion| References|

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