Gastrointestinal stromal tumour presenting with duodenal-jejunal intussusception: a case report

Wall, Michael L.; Ghallab, Mohammed; Farmer, Martin; Durkin, Damien

doi:10.1308/147870810x12822015504527

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…negative for malignancy. Wall et al (19) reported the case of a 36-year-old woman with a 15-cm GIST in the second part of the duodenum who underwent pyloruspreserving pancreaticoduodenectomy due to the large size of the tumor and inseparable adhesion to the head of the pancreas. A 91-year-old Japanese woman with a GIST in the third portion of the duodenum received a segmental duodenectomy without reduction of the intussusception but did not undergo a pancreaticoduodenectomy due to her age and performance status (30).…”

Section: Discussionmentioning

confidence: 99%

Jejunojejunal intussusception with chronic bleeding caused by gastrointestinal stromal tumor: a case report and literature review

Li¹,

Ren²,

Sun³

et al. 2022

J Gastrointest Oncol

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Background: Intussusception is a rare clinical condition in adults. The majority of patients present with symptoms of bowel obstruction. Intussusception is often misdiagnosed and the majority of cases are diagnosed intraoperatively. In this paper, we present a rare case of adult jejunojejunal intussusception with chronic bleeding caused by a gastrointestinal stromal tumor (GIST). We emphasize the role of contrastenhanced computed tomography (CT) and enteroscopy in the presurgical diagnosis and the good prognosis in the high-risk GIST patient after surgery and targeted therapy.Case Description: Herein, we present the case of a 63-year-old female patient with small bowel intussusception with chronic bleeding caused by a GIST. Her main symptoms were intermittent melena and progressive anemia. She had a 20-year history of hypertension and had never undergone previous abdominal surgery. After failure of an esophagogastroduodenoscopy and colonoscopy to locate the hemorrhagic foci in the gastrointestinal tract, contrast-enhanced CT and enteroscopy were used and a small bowel intussusception and an intraluminal mass with a bleeding ulcer was identified. The patient underwent laparoscopic partial small bowel resection, and postoperative pathological examinations showed a small intestinal GIST with a high risk of recurrence. It was suggested that the patient take imatinib regularly for at least 3 years. At the time of writing, she has remained in good health without relapse for 24 months after discharge. We also review 20 published cases of intussusception caused by small bowel GIST in the PubMed database.Conclusions: Obscure gastrointestinal hemorrhage needs meticulous examinations to promptly determine the cause and location of bleeding. This case and literature review revealed that comprehensive surgical resection-centered treatment was the standard treatment for primary localized GISTs in patients at significant risk of relapse.

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Section: Discussionmentioning

confidence: 99%

Jejunojejunal intussusception with chronic bleeding caused by gastrointestinal stromal tumor: a case report and literature review

Li¹,

Ren²,

Sun³

et al. 2022

J Gastrointest Oncol

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“…Together, they are variably prominent components of three syndromes: the familial paraganglioma and gastric GIST syndrome, neurofibromatosis type 1, and the Carney triad (syndrome with paraganglioma-jejunal GIST combination). The two former conditions are inherited as autosomal dominant traits; the later does not appear to be inherited and affects young women predominantly [11].…”

Section: Discussionmentioning

confidence: 99%

“…The endoscopic video capsula plays an important role in the diagnosis of stromal hemorrhagic tumors of the small intestine. It is a simple and harmless examination, that represents at present the examination of first intention in the case of an unexplained digestive haemorrhage after normal oesogastro duodenal endoscopy and an ileo coloscopy 1,2,4,9,10.The endoscopic video capsula made it possible to put the diagnosis of tumors of the small intestine in 8%, 9% of the cases [1,2,9,11,12]. Surgery is the primary treatment of choice and for a long time has been the only effective treatment for GIST with overall 5-year survival rates of 45% -55% until 2001 when Imatinib, a Open Access IJCM Jejunal Stromal Tumor Revealed by a Digestive Hemorrhage Open Access IJCM 487 small molecule inhibiting the kinase activity of c-kit, was recognized to be highly effective in metastasized GIST and revolutionized the treatment of metastasized and/or unresectable GIST [13,14].…”

Section: Discussionmentioning

confidence: 99%

Jejunal Stromal Tumor Revealed by a Digestive Hemorrhage

Moujahid¹,

Ennafae²,

Ghari³

et al. 2013

IJCM

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Introduction: Gastro intestinal stromal tumors are rare which can arise at any age, mostly between 50 and 60 years old. They are characterized by the expression on the surface of their cells, a specific gene c-kit. They can be located in any segment of the digestive tract, with a preference for the stomach (60%). The jejunum location is found in 200% to 30% of the cases. The originality of our observation is the revelation of a stromal jejunum tumor by a digestive bleeding. Case Report: A 71-year-old man was admitted in emergencies for a low digestive plentiful bleeding with state of hypovolemia shock. Result: The operation was performed after stabilization of his dynamic state and blood transfusion and we discovered a jejunal stromal tumor in operation. The follow-up was simple with a good evolution under treatment by Imatinib. Conclusion: Stromal digestive tumors are rare which can interest all the segments of the digestive tract and their diagnosis must be often evoked in front of any digestive bleeding.

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“…In the reviewed literature, endoscopic polypectomy was adopted in one patient [18]; however, open surgeries were conducted in all the other patients, including 31 local excisions, 12 segmental duodenectomies with gastroduodenal anastomosis [1,2,38] or duodenojejunal anastomosis [6,9,15,20,23,39,40,42], and four pancreatoduodenectomies [22,24,25,33].…”

Section: Discussionmentioning

confidence: 99%

Duodenal intussusception due to a giant neuroendocrine carcinoma in a patient with Peutz–Jeghers syndrome

Chen

Yu²,

Yang³

et al. 2012

European Journal of Gastroenterology & Hepatology

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Duodenal intussusception is a rare entity. To date, only a few cases have been reported in the literature. In this report, a case of duodenal intussusception due to an unusual tumor was presented and the clinical features of this entity were discussed. A 42-year-old man with Peutz-Jeghers syndrome presented with epigastric pain, vomiting, and severe anemia. Computed tomography scan revealed synchronous duodenojejunal and jejunojejunal intussusceptions. An emergency laparotomy revealed a polypoid mass originating from the lateral wall of the descending duodenum with intussusception of the distal duodenum. Histological examination demonstrated a poorly differentiated neuroendocrine carcinoma with muscularis infiltration, vascular invasion, and a Ki-67 index of 20%. A comprehensive literature search revealed 44 English reports that provided adequate descriptions of an additional 47 such cases. Clinical presentation was usually chronic and nonspecific. Diagnostic modalities included ultrasonography, upper gastrointestinal series, computed tomography, and endoscopy. Five patients were due to a non-neoplastic lesion; however, the other 43 patients were secondary to a tumor, benign in 35 cases and malignant in eight cases. Only one patient was treated by endoscopic polypectomy, whereas the remaining underwent open surgeries. Duodenal intussusception is a challenging condition due to its rarity and nonspecific presentation. It should be considered in the differential diagnosis of gastric outlet obstruction, upper gastrointestinal bleeding, pancreatitis, and obstructive jaundice.

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Gastrointestinal stromal tumour presenting with duodenal-jejunal intussusception: a case report

Cited by 9 publications

References 12 publications

Jejunojejunal intussusception with chronic bleeding caused by gastrointestinal stromal tumor: a case report and literature review

Jejunojejunal intussusception with chronic bleeding caused by gastrointestinal stromal tumor: a case report and literature review

Jejunal Stromal Tumor Revealed by a Digestive Hemorrhage

Duodenal intussusception due to a giant neuroendocrine carcinoma in a patient with Peutz–Jeghers syndrome

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