Abstract
An 85–year–old man seen locally for abdominal pain starting in early morning in July 2005 was found in abdominal plain radiography to have an intestinal obstruction, and referred for hospitalization the same day. On admission, he showed right abdominal tenderness and an abdominal mass was palpated. Abdominal computed tomography (CT) showed a 3 cm lower right abdominal mass with mesenteric arteries and veins continuous with this lesion in a spiral—the so–called “whirl sign.” A diagnosis of small intestine tumor with small intestinal volvulus necessitated surgery that day. Laparotomy showed a small discolored dark–red tumor 10 cm from Treitz′ ligament. This tumor had caused the small intestine to rotate 360° with the superior mesenteric vessels as the rotational axis. Torsion was released and the small intestine partially resected. Histopathologically, the diagnosis was gastrointestinal stromal tumor (GIST) of the small intestine with a maximum diameter of 5.7 cm. Immunostaining showed the tumor was positive for c–kit (+), CD34 (+), SMA (+), and S–100 (+). The man remains recurrence–free 5 years after surgery.
