Diagnosis of gastrointestinal stromal tumors (GISTs) in the distal small intestine is difficult by endoscopic ultrasound. This is the first reported case of an ileal GIST, which is diagnosed by transabdominal sonography and strain elastography. A 75 y/o woman presented with tarry stool and dizziness. No definite bleeder could be identified by esophagogastroduodenoscopy and colonoscopy. The transabdominal sonography revealed a large heterogeneous tumor involving the muscular layer of the ileum. Strain elastography showed the strain ratio was 6.51. Strain histogram was skewed to the blue side, and mean color value was 230.5, signifying a stiff tumor. GIST was highly suspected. The patient underwent laparoscope-assisted tumor excision and the histological examination confirmed a malignant GIST. The patient was discharged without postoperative event. Transabdominal strain elastography could play a role to discriminate small bowel GISTs and other submucosal tumors, especially in the location with difficulty in endoscopic ultrasound.

中文翻译：

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回肠弹性成像在回肠胃肠道间质瘤的诊断工具中的应用

内镜超声难以诊断远端小肠的胃肠道间质瘤（GIST）。这是首次报告的回肠GIST病例，通过腹部超声检查和应变弹性成像诊断。一位75岁的女性表现出柏油样便和头晕。食管胃十二指肠镜检查和结肠镜检查不能鉴定出明确的出血。经腹超声检查发现一个大的异质性肿瘤累及回肠的肌肉层。应变弹性成像显示应变比为6.51。应变直方图偏向蓝色侧，平均色值为230.5，表明肿瘤僵硬。GIST被高度怀疑。该患者接受了腹腔镜辅助的肿瘤切除术，组织学检查证实为恶性GIST。该患者出院无术后事件。