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Fukuda S, Fujiwara Y, Wakasa T, et al. Small, spontaneously ruptured gastrointestinal stromal tumor in the small intestine causing hemoperitoneum: A case report. Int J Surg Case Rep. 2017;36:64-68doi: 10.1016/j.ijscr.2017.05.019.
Fukuda, S., Fujiwara, Y., Wakasa, T., Inoue, K., Kitani, K., Ishikawa, H., Tsujie, M., Yukawa, M., Ohta, Y., & Inoue, M. (2017). Small, spontaneously ruptured gastrointestinal stromal tumor in the small intestine causing hemoperitoneum: A case report. International journal of surgery case reports, 3664-68. https://doi.org/10.1016/j.ijscr.2017.05.019
Fukuda, Shuichi, et al. "Small, spontaneously ruptured gastrointestinal stromal tumor in the small intestine causing hemoperitoneum: A case report." International journal of surgery case reports vol. 36 (2017): 64-68. doi: https://doi.org/10.1016/j.ijscr.2017.05.019
Fukuda S, Fujiwara Y, Wakasa T, Inoue K, Kitani K, Ishikawa H, Tsujie M, Yukawa M, Ohta Y, Inoue M. Small, spontaneously ruptured gastrointestinal stromal tumor in the small intestine causing hemoperitoneum: A case report. Int J Surg Case Rep. 2017;36:64-68. doi: 10.1016/j.ijscr.2017.05.019. Epub 2017 May 17. PMID: 28549261; PMCID: PMC5443905.
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Int J Surg Case Rep. 2017;36:64-68. doi: 10.1016/j.ijscr.2017.05.019. Epub 2017 May 17.

Small, spontaneously ruptured gastrointestinal stromal tumor in the small intestine causing hemoperitoneum: A case report.

International journal of surgery case reports

Shuichi Fukuda, Yoshinori Fujiwara, Tomoko Wakasa, Keisuke Inoue, Kotaro Kitani, Hajime Ishikawa, Masanori Tsujie, Masao Yukawa, Yoshio Ohta, Masatoshi Inoue

Affiliations

  1. Department of Gastroenterological Surgery, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  2. Department of Gastroenterological Surgery, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  3. Department of Pathology, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  4. Department of Gastroenterological Surgery, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  5. Department of Gastroenterological Surgery, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  6. Department of Gastroenterological Surgery, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  7. Department of Gastroenterological Surgery, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  8. Department of Gastroenterological Surgery, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  9. Department of Pathology, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].
  10. Department of Gastroenterological Surgery, Kindai University Nara Hospital, Nara, Japan. Electronic address: [email protected].

PMID: 28549261 PMCID: PMC5443905 DOI: 10.1016/j.ijscr.2017.05.019

Abstract

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are clinically asymptomatic until they reach a significant size; therefore, GISTs that are 2cm or less are typically asymptomatic. Patients with symptomatic GISTs typically present with abdominal pain, gastrointestinal bleeding, or a palpable mass but rarely present with hemoperitoneum.

PRESENTATION OF CASE: A 72-year-old Japanese man presented to us with acute onset abdominal pain. Physical examination showed peritoneal irritation in the lower abdomen. Findings of abdominal computed tomography were suggestive of hemoperitoneum; therefore, urgent surgery was performed. Approximately 1500ml of blood in the abdominal cavity was removed. A small, ruptured mass was found in the middle of the small intestine, and partial resection of the small intestine, including the mass, was performed. The resected tumor was 2cm in size and exhibited an exophytic growth pattern. Immunohistochemical staining revealed that the tumor was positive for KIT and CD34; therefore, a final diagnosis of GIST was made. Treatment with imatinib at 400mg per day was started from postoperative month 1. The patient is doing well without recurrence 5 months after surgery.

DISCUSSION: Even small GISTs in the small intestine can spontaneously rupture and cause hemoperitoneum. Moreover, when a patient presents with sudden abdominal pain and hemoperitoneum without an evident mass on imaging, clinicians should be aware of the possibility of bleeding from a small GIST in the small intestine.

CONCLUSION: We present an extremely rare case of a patient with a small, spontaneously ruptured GIST in the small intestine, resulting in hemoperitoneum.

Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Keywords: Case report; Gastrointestinal stromal tumour; Haemoperitoneum; Imatinib; Small intestine; Tumour rupture

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