A CASE OF DUPLICATION OF THE SMALL INTESTINE WITH MASSIVE ANAL BLEEDING

Abstract

A 14-year-old male was admitted to the hospital because of sudden onset of massive anal bleeding. He was in shock state. Superior mesenteric angiography reveled a tumor like stain next to the small intestine. Arterial CT enhanced the tumor hyperdensity, and detected air within the tumor. A laparotomy was done, and a sacciform tumor 8 cm in diameter was growing out of the jejunum's mesenteric side was found. Partial resection of the small intestine was carrid out. Gastric mucosa spreaded with the entire lumen of the tumor. The lumen of the tumor communicated with the small intestine's via an opening 12×13 mm in diameter. The muscle layer of the tumor wall continued to the small intestine's. Ul-III ulcer 15 mm in length was found on mucosa of the small intestine beside the opening. We think that the ulcer was the bleeding site. The patient was diagnoseed a having duplication of the small intestine with ectopic gastric mucosa. The superiority of angiography in detecting a small bowel lesion with ectopic gastric mucosa was demonstrated. A angiography is effective to detect the small intestinal tumor having the gastric mucosa.