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Kidwai, Bangalore
February 2008

HISTORY:

54 year old lady. Presented with GI bleed. Normal gastroscopy. Small bowel lesion at laparotomy with a very prominent bleeding vessel. Small bowel (jejunum) Resection.

Gross findings A segment of small bowel measuring 65 mm in length. At 20 mm from the closest resection margin is a pale, sub-mucosal nodule measuring 17 x 15 mm. The serosal surface is unremarkable. On opening the bowel, the nodule is confined to sub-mucosal bowel wall with no mucosal ulceration. Cut-surface of the nodule shows a pale, fleshy appearance. A portion of small bowel mesentery is attached with no thrombus present in the vascular tie. Digital images from the nodule.

Smooth muscle actin