PMC6260360_01
CT scan showing a large tumor arrising from the first jejunal segment: A. Sagital image; B. Coronal image.
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PMC6260360_01_gr1.jpg
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An Angio-CT was requested and showed a large exophytic mass arising apparently from the 4th duodenal segment and first jejunal segment with approximately 20 x 14 x 13 cm, with vascularization provided from branches from the upper mesenteric artery, with vascular dilatations inside the tumor and apparent intratumoral bleeding, without intraperitoneal bleeding (Fig. 1).
Image of the tumor found during exploratory laparotomy.
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Due to haemodynamic instability the patient was submitted to emergency laparotomy, in witch a large tumor was found arising from the first jejunal segment (2 cm after duodenual-jejunal flexure) (Figs. 2e and 3 ).
Detail of the tumoral mass arrising from the first jejunal segment.
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Due to haemodynamic instability the patient was submitted to emergency laparotomy, in witch a large tumor was found arising from the first jejunal segment (2 cm after duodenual-jejunal flexure) (Figs. 2e and 3 ).
Image of the duodenal-jejunal anastomosis.
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A side-to-side manual anastomosis was performed between the 3rd duodenal segment and the jejunum (Fig. 4).