2012 Volume 45 Issue 7 Pages 809-815
Abdominal CT in a 40-year-old man admitted for severe abdominal pain was found to have his small intestine compressed by multiple intra-abdominal tumors, leading to small intestinal ileus with ascites. Emergency surgery was performed because the presence of a strangulated ileus could not be ruled out. At surgery, a tumor 4.5 cm in diameter at the edge of the greater omentum was found under the umbilicus, partially covered by sloughing of pus and compressing the small intestine. The tumor was resected to resolve the small intestinal ileus. Moreover, another tumor 5.0 cm in diameter, detected around the lesser curvature of the stomach, was resected simultaneously. Numerous small white nodules were found on the surface of the greater omentum, lesser omentum and mesenterium. The resected specimens from the greater and lesser omentum were 5.0×3.5 and 5.0×4.6 cm in size, respectively. Both of them showed multinodular tumors on their surface. Consequently, according to the histopathological findings, the definitive diagnosis of those tumors was inflammatory myofibroblastic tumor derived from the greater and lesser omentum, and the numerous small white nodules were tumors due to inflammatory reactions. In Japan, reports of multiple inflammatory myofibroblastic tumors arising from the greater and lesser omentum are extremely rare, and a case of those tumors leading to small intestinal ileus is unprecedented in the literature.
