Small Bowel GIST: Clinical Presentation as Intussusception and Obscure Bleeding (original) (raw)
Related papers
Jejunojejunal intussusception caused by a jejunal gastrointestinal stromal tumour (GIST)
Hellenic Journal of Surgery, 2014
Introduction: Adult intussusception represents a challenge to the surgeon as it can cause acute, subacute or chronic non-specific obstruction and presents with dubious clinical features. Case Report: A forty-six-year-old female presented with progressively worsening abdominal pain, mild abdominal distension, anorexia, profuse vomiting and constipation that had begun thirty six hours earlier. Discussion: Primary or metastatic malignancies are responsible for 14-47% of all small bowel intussusceptions; in the large bowel 66% of cases have malignant aetiology. In contrast, abdominal X-rays display an intussusception as stacked coins or a coiled spring in the upper GI series and cup-shaped defect in contrast enema. The treatment of choice in adult intussusception is always surgical. Conclusion: Adult intussusception is a rare entity that may present a diagnostic dilemma due to its non-specific symptoms. However, controversy surrounds the need for reduction and extent of surgical resection.
Jejunoileal GIST: A Rare Case of Transient Intussusception and Gastrointestinal Bleeding
Case Reports in Surgery, 2019
Gastrointestinal stromal tumors (GIST) comprised 0,2% of all GI tumors. They are typically asymptomatic, but can manifest with nonspecific GI symptoms, GI bleeding, or intussusception. The authors report a case of a 55-year-old female patient with hematochezia and a palpable mass on the left lower quadrant. Ultrasound revealed possible intussusception. However, CT scan did not show any signs of lesions or intussusception. On reevaluation, the mass was no longer palpable. The patient had recurrent episodes of hematochezia with need of transfusional support. CT enterography revealed a 20-24 mm jejunoileal lesion. A laparotomy was undertaken with small bowel resection containing the lesion. Histological examination confirmed GIST. GIST presentation as transient intussusception and intermittent GI bleeding is rare. This case report emphasizes the rarity of jejunoileal GIST, its clinical details, diagnostic study, and treatment.
Intussusception due to gastro-intestinal stromal tumor (GIST): A case report
2005
Objective: The authors present a rare manifestations of stromal tumors; an ileal tumor leading to intussusception. Material and methods: (Case report), a 39 years old female patient: Present colycky abdominal pain and constipation for 15 days; seven days prior to the admission she had a single episode of diarrhea with blood, physical examination reveled mild pallor; an abdominal mass measuring 10 cm at the right flank. Plain abdominal xray demonstrated a soft tissue mass effect and atypical absence of gas at the right flank. Ct scanning was performed, revealing thickening of the right colon and an image of concentric layers, highly suggestive of intussusception, barium enema confirmed the diagnosis. Treatment: Exploratory laparotomy was performed and surgical findings were compatible with ileocolic intussusception, a right colectomy with resection of the invaginatedilium was done followed by primary anastomosis. Results: Histopathological studies confirmed a 2.4 cm gastro-intestinal stromal tumor (gist), 21 cm from the ileocecal valve compromising only the submucosae. Immunohistochemical test were positive for CD 117 (C-KIT), CD 34, 1a4 and vimentin. Mitotic rate was lower than 5/50 high-power fields (HPF). Discussion: Intussusception occurs rarely in adults (less than 5%) and is responsible for only 1% of the all cases of the obstruction in this group, in 95% of occurrences, etiology is identifiable. Symptoms are related to the location of the tumor. Gastric lesions more often present with bleeding (60-70%).
Jejunojejunal Adult Intussusception Presented with Rectal Bleeding
Journal of gastroenterology and hepatology research, 2012
Jejunojejunal adult intussusception is a rare disease. Secondary small intestine intussusception is even rarer and may result from intraluminal or extraluminal lesions. Adenocarcinoma may be found in up to 30% of small-intestine intussusception cases. We present a case of a 65 year old woman, who presented in the accident and emergency department of a rural hospital with lower gastrointestinal bleeding and abdominal pain. The patient underwent emergent gastroenterology and surgical consultation, imaging studies, urgent surgical therapy. Diagnosis of small-bowel adenocarcinoma was made on the basis of histologic examination. The patient had no risk factors for small-bowel adenocarcinoma. She did not receive chemotherapy after surgical therapy. She has been on a regular follow-up, without evidence of locoregional relapse or metastases. The probability for a given adult in Greece to present with rectal bleeding because of small bowel intussusception is estimated to be 1 to 2 cases annually in a 10 000 000 population. The probability that the cause of intussusception is primary adenocarcinoma is even smaller. The disease has no specific symptoms or signs. High degree of clinical suspicion is needed in order a diagnosis will not be missed.
Adult intussusception by tumor in ileum: a diagnostic dilemma
Intussusception in adults is an infrequent cause of intestinal obstruction; preoperative diagnosis is difficult as symptoms can be intermittent and long standing. This relatively rare entity differs from the childhood form in its etiology, presentation and treatment. We present two cases of ileo-colic intussusception in adults, with a clinical presentation that mimicked complicated appendicitis. These cases remind us that both ileal tumors and intussusception must be included in the diagnosis of lower abdominal pain.
An Infrequent Case Of Intussuception Caused By Gastrointestinal Stromal Tumour In An Adult Patient
Northern Clinics of Istanbul, 2016
Intussusception may occur anywhere in the gastrointestinal system. Unlike its idiopathic childhood counterpart, it is uncommon during adult life and a definitive cause is usually found; almost half of cases develop with malignancy. Gastrointestinal stromal tumors (GIST) originate from interstitial Cajal cells of the gastrointestinal tract. They more frequently occur in the stomach and small intestines, and often grow extraluminally, making it unlikely to cause an obstruction or bleeding. Presently described is an unusual instance of ileo-ileal intussusception due to GIST.
Hippokratia, 2019
BACKGROUND Bowel intussusception in adults remains a rare and constant diagnostic challenge for surgeons. It has an incidence of around 2-3 new cases per million per year, and its primary cause is benign or malignant neoplasms of the small bowel and colon. This report aims to outline the importance of high clinical suspicion regarding intussusception in adults presenting with abdominal pain in the emergency department. Case report: This is a retrospective review of three cases of adult ileocecal intussusception that were treated in a single surgical department in three years (2015-2018). All patients underwent right hemicolectomy in keeping with the principles of surgical oncology. Each patient had a different clinical presentation, while, in terms of the underlining pathology, the first had an adenocarcinoma of the ascending colon, the second an adenocarcinoma of the ileocecal valve, and the third one an inflammatory fibroid polyp of the ileocecal valve, also known as Vanek's ...
The Pan African medical journal, 2011
Gastrointestinal stromal tumors (GIST) are mesenchymal tumors occurring anywhere along the gastrointestinal tract and are believed to originate from the interstitial cells of Cajal. They commonly arise in the stomach or small intestine. The usual growth pattern is exophytic invading adjacent organs or perforation into the peritoneal cavity which may result in bleeding or obstructive symptoms. Intussusception and obstruction is a very uncommon presentation of these lesions because of their tendency to grow in an extraluminal fashion. We report an unusual case of 59 yrs old man presenting with acute small bowel obstruction, which on exploration was found to be due to ileo-ileal intussusception and the lead point of intussusception was a tumor, which was histologically diagnosed as GIST