A case of a diverticulum-like giant jejunal gastrointestinal stromal tumour presenting with intraperitoneal peritonitis due to rupture
| Autor: | Ryosuke Arata, Toshiyuki Itamoto, Takashi Urushihara, Takashi Nishisaka, Hideki Nakahara |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Abdominal pain Gastrointestinal stromal tumour Perforation (oil well) Peritonitis Rupture of the tumour Abdominal cavity Article 03 medical and health sciences 0302 clinical medicine Hematoma Ascites medicine Chemotherapy neoplasms Gastrointestinal tract GiST business.industry GIT gastrointestinal tract Small intestine medicine.disease digestive system diseases Surgery CT computed tomography medicine.anatomical_structure 030220 oncology & carcinogenesis Local resection 030211 gastroenterology & hepatology GIST gastrointestinal stromal tumour medicine.symptom business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Diagnosing GIST is difficult due to the absence of clinical symptoms. • GIST should be considered when sudden abdominal pain and a mass are present. • We present a case of a GIST with partial resection and drainage surgery. • Ensuring local resection and proper chemotherapy increases long-term survival. Introduction Early diagnosis of small intestinal gastrointestinal stromal tumours (GISTs) is difficult. These tumours often present with peritonitis and intraperitoneal bleeding due to rupture. We experienced a case of a tumor that grows to 12 cm asymptomatic. Presentation of case A 46-year-old man presented with sudden abdominal pain. Computed tomography revealed free air in the abdominal cavity, a 12-cm sized dilatation in the small intestine, and pooled residues. He was diagnosed with perforation of the gastrointestinal tract, and emergency surgery was performed. Inside the abdominal cavity, approximately 500 mL of bloody ascites was observed. A diverticulum-like mass measuring approximately 12-cm long was observed on the jejunum approximately 30 cm from the Treitz ligament. There was a large hematoma inside the mass, and perforation was recognised at the neck of the diverticulum. Partial resection of the jejunum and intraperitoneal drainage were performed. Immunohistochemistry revealed that the tumour was positive for KIT and CD34, and GIST was diagnosed. The patient was discharged on postoperative day 10 without significant complications. The patient did not relapse while taking imatinib as an adjuvant chemotherapy. Discussion Gastrointestinal stromal tumours are the most common mesenchymal tumours of the gastrointestinal tract and may undergo increased diverticulum-like growth, as seen in this case. Local resection and proper chemotherapy increase long-term survival, suppress tumour growth, and reduce the risk of relapse. Conclusion Diagnosing GIST can be difficult due to the absence of clinical symptoms. It is necessary to ensure local resection and careful long-term follow-up. |
| Databáze: | OpenAIRE |
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