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Imaging-Guided Minimally Invasive Laparoscopic Resection of Intraluminal Small-Bowel Tumor: Report of Two Cases

Joon Seok Lim1, Woo Jin Hyung2, Mi-Suk Park3, Myeong-Jin Kim3, Sung Hoon Noh2 and Ki Whang Kim3

1 Department of Diagnostic Radiology, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
2 Department of Surgery, Yonsei University College of Medicine, 134 Shinchondong, Seodaemoon-Gu, Seoul, South Korea.
3 Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, South Korea.


Figure 1
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  		Fig. 1A —46-year-old man with cystic lymphangioma causing gastrointestinal bleeding. Preoperative coronal reformatted CT image shows multilobular low-attenuation mass (arrows) in mid jejunum. Lesion has intraluminal growth pattern.

 

Figure 2
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  		Fig. 1B —46-year-old man with cystic lymphangioma causing gastrointestinal bleeding. Curved planar reformatted image shows measured distance (42.6 cm) between level of ligament of Treitz (arrowhead) and proximal margin of lesion (arrow).

 

Figure 3
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  		Fig. 1C —46-year-old man with cystic lymphangioma causing gastrointestinal bleeding. Laparoscopic photograph shows localization of lesion with 10-cm length of suture material.

 

Figure 4
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  		Fig. 1D —46-year-old man with cystic lymphangioma causing gastrointestinal bleeding. Laparoscopic photograph shows sonographic probe searching lesion. Serosal color change is present in proximal portion of presumed location (arrows).

 

Figure 5
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  		Fig. 1E —46-year-old man with cystic lymphangioma causing gastrointestinal bleeding. Laparoscopic sonogram shows multicystic lesion at estimated location (arrows).

 

Figure 6
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  		Fig. 1F —46-year-old man with cystic lymphangioma causing gastrointestinal bleeding. Photograph of specimen shows intraluminal mass with papillary growth pattern. Pathologic finding was cystic lymphangioma.

 

Figure 7
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  		Fig. 2A —56-year-old man with ulcerated lipoma causing gastrointestinal bleeding. Transverse contrast-enhanced CT image shows fatty intraluminal mass (arrow) in mid ileum.

 

Figure 8
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  		Fig. 2B —56-year-old man with ulcerated lipoma causing gastrointestinal bleeding. Curved planar reconstruction shows distance between ileocecal valve (arrowhead) and lesion (arrow).

 

Figure 9
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  		Fig. 2C —56-year-old man with ulcerated lipoma causing gastrointestinal bleeding. Laparoscopic photograph shows questionable bulbous contour (arrows) without serosal color change in proximal portion of presumed location of lesion. Laparoscopic sonographic probe is searching lesion.

 

Figure 10
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  		Fig. 2D —56-year-old man with ulcerated lipoma causing gastrointestinal bleeding. Laparoscopic sonogram shows hyperechoic round mass in presumed location (arrows) of mass.

 

Figure 11
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  		Fig. 2E —56-year-old man with ulcerated lipoma causing gastrointestinal bleeding. Photograph shows submucosal intraluminal mass with central ulceration. Pathologic finding was lipoma.

 

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