A 56-YEAR-OLD man sought treatment because of bloody stools and syncope. He underwent a transfusion and an esophagogastroduodenoscopy, which showed a hiatal hernia and mild gastritis but no source of bleeding. Results of a colonoscopy were normal. Although the bleeding spontaneously resolved, during the subsequent 2 years, he continued to have trace hemoccult-positive stools and was treated for reflux esophagitis. A routine chest radiograph demonstrated an abnormality in his mediastinum. A computed tomographic scan showed a large hiatal hernia and a 7 × 5-cm incidental mass in the abdomen (Figure 1). Subsequently, an esophagogastroduodenoscopy was performed, and it showed a submucosal mass between the third to fourth portions of the duodenum (Figure 2).
D.Small-bowel stromal tumor
Accepted for publication March 8, 2002.
Corresponding author and reprints: Terrence H. Liu, MD, Department of Surgery, University of California, San Francisco–East Bay, 1411 E 31st St, Oakland, CA 94602.
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