Adult Intussusception due to Gastrointestinal Stromal Tumor: A Rare Case Report, Comprehensive Literature Review, and Diagnostic Challenges in Low-Resource Countries

Abstract

We present a rare case of gastrogastric intussusception due to gastrointestinal stromal tumor (GIST) and the largest comprehensive literature review of published case reports on gastrointestinal (GI) intussusception due to GIST in the past three decades. We found that the common presenting symptoms were features of gastrointestinal obstruction and melena. We highlight the diagnostic challenges faced in low-resource countries. Our findings emphasize the importance of early clinical diagnosis in low-resource settings in order to guide timely management. In addition, histological analysis of the tumor for macroscopic and microscopic characteristics including mitotic index and c-Kit/CD117 status should be obtained to guide adjuvant therapy with imatinib mesylate. Periodic follow-up to access tumor recurrence is fundamental and should be the standard of care.

Life-threatening bleeding with intussusception due to gastrointestinal stromal tumor: a case report

“…A review of 18 cases of intussusception secondary to GIST found that approximately 39% (7/18) of GISTs were within the small bowel. None of them had massive bleeding symptoms [2–6]. Thus, our case is the first reported and extremely rare manifestation presented as small bowel intussusception with massive bleeding from GIST.…”

“…Small bowel intussusception from GIST in adults has been described in a few cases in the literature. Most of the reported adult cases manifested in abdominal pain and obstruction symptoms, with no symptoms of massive bleeding [2–6]. Cases of GIST with massive bleeding without intussusception are rarely described in the literature [7, 8].…”

Gastroduodenal intussusception as a rare cause of pancreatitis in a young female Ugandan: A case report

“…GIST tumors are the most common cause of gastroduodenal intussusception. At 23 years, this patient is younger than the other previously reported cases of GISTs causing gastroduodenal intussusception (Mean age 64.5, median age 65 and range 29–95 years) [14] , [15] .…”

Imperforate hymen and leaking hematosalpinx mimicking acute appendicitis: A report of a rare case and a review of literature

“…Ultrasound scan will show an echogenic fluid accumulation in the vagina that can extend to uterus. In low-resources setting like ours, however, imaging modalities may not be available [9,10].…”