Therapeutic Challenges in the Management of Bleeding Duodenal Gastrointestinal Stromal Tumor: a Case Report and Review of Literature

Abstract

Introduction: Duodenum is an uncommon site for the gastrointestinal stromal tumors (GISTs). Though the principles of management are the same of that elsewhere in the gastrointestinal tract, the anatomical complexity poses challenges in deciding the most appropriate treatment. A bleeding GIST further compounds the difficulty in managing such patients.

Case report: A twenty-eight-year-old female presented with bleeding duodenal lesion secondary to mucosal ulceration. Imaging confirmed large heterogeneous lesion arising from the second part of duodenum. Surgery was planned in view of persistent blood transfusion requirement. Pancreaticoduodenectomy was done and the patient had an uneventful postoperative period.

Discussion: Review of literature of duodenal GIST especially regarding the tough decisions that have to be made in the diagnosis and management of bleeding lesions has been done.

Conclusion: The availability of various options in addressing bleeding duodenal GIST should make the surgeon choose the best modality for the patient weighing the pros and cons of each modality.

Keywords: Bleeding; Duodenum; Gastrointestinal stromal tumor; Imatinib; Pancreaticoduodenectomy.