Jejunal GIST causing acute massive gastrointestinal bleeding: Role of multidetector row helical CT in the preoperative diagnosis and management

Daldoul, S.; Moussi, Amir; Triki, Wissem; Baraket, Rym Bennaceur; Zaouche, A

doi:10.1016/j.ajg.2012.08.005

Cited by 16 publications

(15 citation statements)

References 22 publications

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“…Retrospectively, we realized and assumed that the magnitude of bleed may depend upon the location along mesenteric border with direct mesenteric feeding vessels. Stromal collagen is minimal in most GISTs, but delicate, thin-walled vessels may be prominent, making stromal haemorrhage a common feature of these tumours [13]…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Diagnostic and Therapeutic Challenges in The Management of Acute Massive Overt Bleeding of Jejunal Gastrointestinal Stromal Tumours: Case Series

Deivasigamani

Aruni

et al. 2021

Preprint

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Introduction: Jejunal Gastro-Intestinal Stromal Tumours (GIST) are rare mesenchymal tumours. Acute massive overt bleeding from jejunal GIST are very rare and poses both diagnostic and therapeutic challenges in emergent conditions. Methods A case series with retrospective analysis of prospectively maintained database of patients presenting with acute massive overt bleeding secondary to histologically proven jejunal GIST was done. Clinical characteristics, endoscopic and imaging diagnostic features, histological findings, surgical procedures and outcomes in these patients were studied. Results Three patients were included in this case series. Mean age of presentation was 49.0 years with two male and one female patient. All three patients presented with melena and hemodynamic instability, resuscitated with adequate blood transfusions. Routine endoscopic assessment were inconclusive. Multiphasic Computed Tomographic Angiography (CTA) revealed hypodense hypervascular mass in jejunum in all three patients. One patient was unresponsive to blood transfusion and underwent emergency exploratory laparotomy. One patient underwent laparoscopic resection and reconstruction. Mean length of hospital stay was 5.3 days. Histopathological examination confirmed Jejunal GIST in all three patients with microscopically negative resection margins. Two patients were disease free till 18 months follow up and the one patient lost to follow up after 1 year. Conclusion Multiphasic CTA is a single step diagnostic tool for localisation of bleed and assessment of tumour characteristics in emergent conditions. Surgical resection is the mainstay of treatment for both control of bleed and to provide oncologically clear resection margins.

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Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Diagnostic and Therapeutic Challenges in The Management of Acute Massive Overt Bleeding of Jejunal Gastrointestinal Stromal Tumours: Case Series

Deivasigamani

Aruni

et al. 2021

Preprint

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“…Furthermore, excision of nearby adjacent organs so that to avoid rupture of the capsule and hence spillage into the abdominal cavity should be kept in mind. These tumors have no tendency to metastasize to lymph nodes, making lymphadenectomy no necessary (8). The role of mini invasive surgery such as laparoscopic approach in GIST resections continue to expand with the bases of traditional open surgery being utilized also in laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Jejunal gastrointestinal stromal tumor (GIST): a case report presenting as life threatening emergency

Saad¹,

Hajj²,

Saikaly³

2020

Gastrointest Stromal Tumor

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Small bowel gastrointestinal stromal tumor (GIST) is an uncommon tumor, with an estimated frequency of 10-20/L million population, occurring usually in the 6 th decade of life. GISTs, mainly ones larger than 4 cm have a wide range of presentations from abdominal discomfort and bloating to abdominal emergencies due to massive gastrointestinal (GI) hemorrhage, with pressure necrosis and ulceration of the overlying mucosa is the main mechanism leading to GI hemorrhage. Life-threatening hemorrhage is a rare initial presentation. Among the wide differential diagnosis for GI bleeding, jejunal GIST is one of the rarest etiologies. Due to its location and hence the inability to identify by endoscopy it is difficult to diagnose. From here, computed tomography (CT) angiography is considered essential for identification of the site of GI bleed, which aids in diagnosis of GIST. The mainstay treatment for this emergent presentation is resection, which if done in a timely manner results in a good clinical outcome. Herein, we report a case of a 46-yearold male patient presenting with massive GI bleed from jejunal GIST, leading to hemodynamic instability, requiring massive transfusion protocol managed by small bowel resection, after failure of radiologic embolization. In rare instances GISTs present as massive GI bleeding necessitating admission to the hospital and urgent interference. In our case the early multidisciplinary approach manifested by involvement of interventional radiology with the surgical team was the cornerstone in the successful management of our patient and should be considered in all cases of massive upper GI bleeding.

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“…Failure to visualize small intestine by endoscopic procedures, tendency of the lesion to demonstrate exophytic extension, and limitations in the evaluation of small intestine by CT under emergency conditions have an impact on the difficulty of the diagnosis [ 6 , 7 ]. GISTs causing bleeding have been described in the literature [ 8 , 9 ]. Our case also had occult bleeding; he had been referred to hospitals for many times with the symptoms of anemia; he had been repeatedly examined and tested but no diagnosis could be achieved.…”

Section: Discussionmentioning

confidence: 99%

Small Intestinal and Mesenteric Multiple Gastrointestinal Stromal Tumors Causing Occult Bleeding

Dinç

Kayilioglu

Erdoğan

et al. 2016

Case Reports in Gastrointestinal Medicine

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Gastrointestinal stromal tumors are the meseancymal neoplasms which may involve any part of gastrointestinal tract. C-Kit and platelet derived factor receptor alpha polypeptide are believed to be responsible for the genetic basis. This case presentation aimed to discuss the diagnostic and therapeutic modality of multiple small intestinal, omental, and mesenteric GISTs with different sizes which caused occult bleeding in a 43-year-old male patient.

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Jejunal GIST causing acute massive gastrointestinal bleeding: Role of multidetector row helical CT in the preoperative diagnosis and management

Cited by 16 publications

References 22 publications

WITHDRAWN: Diagnostic and Therapeutic Challenges in The Management of Acute Massive Overt Bleeding of Jejunal Gastrointestinal Stromal Tumours: Case Series

WITHDRAWN: Diagnostic and Therapeutic Challenges in The Management of Acute Massive Overt Bleeding of Jejunal Gastrointestinal Stromal Tumours: Case Series

Jejunal gastrointestinal stromal tumor (GIST): a case report presenting as life threatening emergency

Small Intestinal and Mesenteric Multiple Gastrointestinal Stromal Tumors Causing Occult Bleeding

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