ABSTRACT
We report herein the case of a 63-year-old male with hemoperitoneum secondary to exogastric leiomyoma. The patient had been receiving anticoagulation therapy for a cerebral embolism and complained of sudden, severe abdominal pain. A sonogram and computed tomography scan showed an exogastric mass and massive ascites. A peritoneal puncture proved the presence of an intraperitoneal hemorrhage. An emergency laparotomy revealed a pedunculated bleeding tumor, thus confirming the preoperative diagnosis of a ruptured exogastric tumor. A microscopic analysis of the excised tumor demonstrated gastric leiomyoma. Other authors have reported hemoperitoneum secondary to gastric myogenic tumors, but no cases of leiomyomas could be found in the literature.
Subject(s)
Hemoperitoneum/etiology , Leiomyoma/complications , Stomach Neoplasms/complications , Biopsy, Needle , Follow-Up Studies , Hemoperitoneum/diagnosis , Hemoperitoneum/therapy , Humans , Laparotomy , Leiomyoma/diagnosis , Leiomyoma/surgery , Male , Middle Aged , Stomach Neoplasms/diagnosis , Stomach Neoplasms/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
In view of the operative field of esophageal cancer, anatomic findings of the bronchial arteries were studied in specimens of 38 cadavers. The number of right and left bronchial arteries were 68 and 61, respectively. The most common branching type was two right and two left arteries, occurring in 36.8% (14/38). Next common type was two right and one left arteries (34.2%). Each specimen had one right intercostobronchial artery and it was considered easy to preserve blood supply to right bronchial artery when cleansing of mediastinal lymphatic chain is performed. But the other 30 right bronchial arteries originating from the aorta coursed, to the area of inferior tracheobronchial lymph nodes, and thus there will be possibility of injury. All of the left bronchial arteries derived from the aorta. The course of 5 left bronchial arteries ran to the area of inferior tracheobronchial lymph nodes, and the one of 41 arteries passed to the area of left tracheobronchial lymph nodes. Therefore, there will be strong possibility of injury to these left bronchial arteries. But the other 19 left bronchial arteries didn't course to any area of lymph nodes, and the arteries can possibly be preserved.
