Display options
Cite
Meneses E, Elkbuli A, Baroutjian A, et al. Perforated proximal jejunal gastrointestinal stromal tumor pT4N0M0 presenting with severe sepsis: A case report and literature review. Ann Med Surg (Lond). 2020;57:76-81doi: 10.1016/j.amsu.2020.07.024.
Meneses, E., Elkbuli, A., Baroutjian, A., McKenney, M., & Boneva, D. (2020). Perforated proximal jejunal gastrointestinal stromal tumor pT4N0M0 presenting with severe sepsis: A case report and literature review. Annals of medicine and surgery (2012), 5776-81. https://doi.org/10.1016/j.amsu.2020.07.024
Meneses, Evander, et al. "Perforated proximal jejunal gastrointestinal stromal tumor pT4N0M0 presenting with severe sepsis: A case report and literature review." Annals of medicine and surgery (2012) vol. 57 (2020): 76-81. doi: https://doi.org/10.1016/j.amsu.2020.07.024
Meneses E, Elkbuli A, Baroutjian A, McKenney M, Boneva D. Perforated proximal jejunal gastrointestinal stromal tumor pT4N0M0 presenting with severe sepsis: A case report and literature review. Ann Med Surg (Lond). 2020 Jul 20;57:76-81. doi: 10.1016/j.amsu.2020.07.024. eCollection 2020 Sep. PMID: 32728434; PMCID: PMC7381426.
Copy Download .nbib Format: NLM
Share it on

Ann Med Surg (Lond). 2020 Jul 20;57:76-81. doi: 10.1016/j.amsu.2020.07.024. eCollection 2020 Sep.

Perforated proximal jejunal gastrointestinal stromal tumor pT4N0M0 presenting with severe sepsis: A case report and literature review.

Annals of medicine and surgery (2012)

Evander Meneses, Adel Elkbuli, Amanda Baroutjian, Mark McKenney, Dessy Boneva

Affiliations

  1. Department of Surgery, Kendall Regional Medical Center, USA.
  2. Department of Surgery, University of South Florida, Tampa, FL, USA.

PMID: 32728434 PMCID: PMC7381426 DOI: 10.1016/j.amsu.2020.07.024

Abstract

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that occur along the alimentary tract, and are most commonly found in the stomach. Rarely, these tumors can occur in the small bowel, and when located in the duodenum or proximal jejunum, they may require challenging reconstruction of the alimentary tract. Patients with GISTs often present with non-specific abdominal pain or symptoms of obstruction, hemorrhage, and less commonly perforation.

PRESENTATION OF CASE: A 46-year-old male presented to the hospital with a one-day history of left upper quadrant pain with fevers and chills. Physical examination was significant for signs of peritonitis, and laboratory results revealed leukocytosis and lactic acidosis. CT abdomen showed a large soft tissue mass in the proximal jejunum. In the operating theater he was found to have a perforated jejunal tumor. Pathology report revealed a 13cm GIST, pT4N0M0, Stage IIIa. He had an uneventful recovery and was discharged nine days after surgery.

DISCUSSION: Proximal jejunal GISTs are a rare entity and when present, perforation is unlikely. Pathological diagnosis of GISTs are relies on immunohistochemistry demonstrating c-KIT or CD34 positivity. The prognosis of GISTs are dependent on the size and the mitotic index. Definitive treatment of non-metastatic GISTs is R0 resection. When located in the duodenum or proximal jejunum, resection can be very challenging and may require clinical expertise in order to safely perform complex alimentary tract reconstruction.

CONCLUSION: Further investigation is required in order to determine best practice management for patients who present with proximal GISTs.

© 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd.

Keywords: Jejunal GIST; Jejunojejunostomy; Perforated GIST; Severe sepsis

Conflict of interest statement

No conflicts of interest.

References

  1. Science. 1998 Jan 23;279(5350):577-80 - PubMed
  2. Ann Surg. 1978 Nov;188(5):689-96 - PubMed
  3. Ann Oncol. 2018 Oct 1;29(Suppl 4):iv68-iv78 - PubMed
  4. Expert Rev Anticancer Ther. 2004 Aug;4(4):595-605 - PubMed
  5. Am J Surg. 1980 Jan;139(1):147-52 - PubMed
  6. Int J Surg. 2018 Dec;60:132-136 - PubMed
  7. Science. 2003 Jan 31;299(5607):708-10 - PubMed
  8. Dis Colon Rectum. 2007 Oct;50(10):1674-87 - PubMed
  9. Turk J Gastroenterol. 2011;22(2):208-12 - PubMed
  10. Turk J Gastroenterol. 2010 Dec;21(4):470-1 - PubMed
  11. Br J Surg. 2007 May;94(5):555-61 - PubMed
  12. Surg J (N Y). 2019 Aug 28;5(3):e92-e95 - PubMed
  13. Eur J Surg Oncol. 2019 Oct;45(10):1950-1956 - PubMed
  14. World J Gastroenterol. 2018 Jul 14;24(26):2806-2817 - PubMed
  15. Int J Surg Pathol. 2002 Apr;10(2):81-9 - PubMed
  16. Oncol Lett. 2012 Dec;4(6):1244-1246 - PubMed
  17. J Natl Compr Canc Netw. 2007 Jul;5 Suppl 2:S1-29; quiz S30 - PubMed
  18. World J Gastrointest Surg. 2012 Sep 27;4(9):208-13 - PubMed

Publication Types