A rare perforated gastrointestinal stromal tumor in the jejunum: A case report

Gastrointestinal stromal tumor (GIST) is a rare stromal neoplasm, which represents the most common mesenchymal tumor of the gastrointestinal tract. It is characterized by indolent clinical symptoms, although it can present as a life-threatening emergency. Herein, we present two cases of primary small bowel GIST treated at our department. A 68-year-old female patient presented to our emergency department with a diffuse abdominal pain of acute onset. Imaging studies revealed a mass at proximal jejunum, with a nearby free air and fluid. At surgery, a mass of 9 cm was found at proximal jejunum, 3 cm distal to the treitz ligament, with perforation on the lateral wall of the mass. En bloc resection was performed. Pathology report was positive for gastrointestinal stromal tumor. A 70-year-old male patient presented to our emergency department with 3 days of dark tarry stool and few hours of hematochezia. Computed tomography angiography revealed a mass at the pelvis, with calcifications, attached to the distal ileum, with intraluminal blush of intravenous iodine. At surgery, a mass of 8 cm at the distal ileum was found. Resection of the mass along with a 20 cm of ileum was completed. Histopathology report was positive for malignant gastrointestinal stromal tumor.

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“…They may also have symptoms secondary to obstruction or hemorrhage. Perforation with acute diffuse peritonitis is rare [4, 15, 16]. …”

Section: Discussionmentioning

confidence: 99%

Primary Small Bowel GIST Presenting as a Life-Threatening Emergency: A Report of Two Cases

Khuri

Gilshtein

Darawshy

et al. 2017

Case Reports in Surgery

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“…However GIST perforation seems to occur more frequently in the small bowel compared to other anatomic sites [35] . Our literature search revealed 21 cases of acute abdomen with diffuse or localized peritonitis caused by spontaneous perforation of small intestine GISTs ( Table 1 ) [9–29] . Two more cases are reported in the case-series of Mansour and Coll [8] .…”

Section: Discussionmentioning

confidence: 99%

“…Few GISTs manifest as abdominal emergencies, such as GI haemorrhage, intestinal obstruction, or tumour perforation [7,8] . Although acute abdomen due to GIST perforation into the peritoneal cavity is rare, a few cases of peritonitis caused by perforation of small-intestinal GISTs have been reported in the literature [8–29] . Together with a review of the published cases, here we report a case of an elderly patient with acute abdomen due to spontaneous perforation of a GIST located in the jejunum.…”

Section: Introductionmentioning

confidence: 99%

Peritonitis secondary to spontaneous perforation of a primary gastrointestinal stromal tumour of the small intestine: A case report and a literature review

Alessiani

Gianola²,

Rossi

et al. 2015

International Journal of Surgery Case Reports

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HighlightsEmergency presentation of a GIST is not uncommon and one of its manifestations is acute abdome.The cases described in the literature are the tip of the iceberg and spontaneous rupture or perforation of GISTs are a far more frequent first presentation of this rare tumour.The jejunum was the more common location of perforation compared to the ileum.Emergency surgery is mandatory and should achieve radical resection.

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“…They may also have symptoms secondary to obstruction or hemorrhage. Perforation with acute diffuse peritonitis is rare [5,7,8].…”

Section: Clinical Featuresmentioning

confidence: 99%

Perforated Gastrointestinal Stromal Tumour of Jejunum

Jain¹,

M²,

Ramalakshmi³

et al. 2020

SASJS

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A 62yr old diabetic male came to emergency department with complaints of abdominal pain and vomiting since 2 days. Physical examination details of patient was pale, dehydrated, had tachycardia and hypotension. Abdomen was distended and had diffuse tenderness and guarding. Free fluid abdomen was present, and bowel sounds were absent. Patient was resuscitated. USG done outside, revealed transverse colon growth. Radiological investigations revealed pneumoperitoneum with growth arising from small bowel. Patient was resuscitated and taken up for emergency laparotomy, which revealed a dumb-bell shaped mass arising from the jejunum with perforation. Resected specimen HPE showed GIST.

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A rare perforated gastrointestinal stromal tumor in the jejunum: A case report

Cited by 11 publications

References 13 publications

Primary Small Bowel GIST Presenting as a Life-Threatening Emergency: A Report of Two Cases

Primary Small Bowel GIST Presenting as a Life-Threatening Emergency: A Report of Two Cases

Peritonitis secondary to spontaneous perforation of a primary gastrointestinal stromal tumour of the small intestine: A case report and a literature review

Perforated Gastrointestinal Stromal Tumour of Jejunum

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