Use of Arteriography and Methylene Blue Tattoo for the Diagnosis of a Jejunal Stromal Tumour

Abstract

A 26-year-old male was referred to our department due to recurring melena. He was hemodynamically stable, with a hemoglobin of 6, and required transfusion of 4 units of concentrated red blood cells. Gastroscopy and colonoscopy were normal. On arteriography, in the jejunum we observed an area of hyper-intensity measuring 3 cm. This was an area of hypertrophic blood vessels (Fig. 1) with no active bleeding, compatible with a vascular malformation or tumor process. The region was marked with methylene blue in order to guide the surgical resection. During surgery, a tumor was found in the stained proximal jejunum and also a Meckel’s diverticulum. The tumor and diverticulum were resected (Fig. 2). The pathology study reported the surgical specimen to be a low-grade gastrointestinal stromal tumor (pT2). c i r e s p . 2 0 1 4 ; 9 2 ( 5 ) : 3 6 2