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. 2019 Oct 24;5(1):154.
doi: 10.1186/s40792-019-0703-9.

Life-threatening bleeding with intussusception due to gastrointestinal stromal tumor: a case report

Min Sung Kim  1   2 , In Teak Woo  3   4 , Young Min Jo  2   5 , Jin Hyung Lee  2   6 , Byung Sam Park  1   2
Affiliations

Life-threatening bleeding with intussusception due to gastrointestinal stromal tumor: a case report

Min Sung Kim et al. Surg Case Rep. .

Abstract

Background: Massive intraluminal bleeding requires urgent intervention and management. However, the source of bleeding on the small intestine is difficult to determine. Intestinal tumor with intussusception is a rare and normally not an urgent condition. Herein, we present a rare case of intestinal intussusception with massive bleeding due to jejunal gastrointestinal stromal tumor (GIST) that required emergency surgical treatment.

Case presentation: A 51-year-old male was admitted to the emergency department complaining of abdominal pain and acute hematochezia. Esophagogastroduodenoscopy (EGD) and colonoscopy could not determine the source of the bleeding site. Abdominal pelvic computed tomography (AP-CT) revealed GIST with intussusception, strongly suggestive of distal jejunal bleeding. Unresponsive transfusion with low blood pressure and continuous hematochezia led to emergency laparotomy. GIST, which was the leading point for intussusception, was located in the jejunum and showed mucosal ulceration of approximately 3.5 cm in diameter. Following resection and functional anastomosis, histology revealed a GIST with low mitotic count (< 5 per 50HPF). Moreover, immunochemical analysis revealed positivity for c-kit (CD117) and DOG-1. There were no complications 2 months after surgery.

Conclusions: Intussusception associated with GIST is a rare finding that can be life-threatening if it occurs with an ulcer. This case showed that the early detection of bleeding and emergency surgery could prevent severe complications.

Keywords: Bleeding; Gastrointestinal stromal tumor; Intussusception.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Colonoscopic finding of unknown origin melena
Fig. 2
Fig. 2
CT scan showing a target sign at the jejunum
Fig. 3
Fig. 3
Intraoperative laparoscopic finding showed intussusception of the jejunum
Fig. 4
Fig. 4
Gross imaging of gastrointestinal stromal tumor
Fig. 5
Fig. 5
Grossly coronal resection of gastrointestinal stromal tumor
Fig. 6
Fig. 6
In high magnification, spindle cells showed elongated nuclei with vesicular chromatin, inconspicuous nucleoli, forming short fascicles
Fig. 7
Fig. 7
Immunohistochemically, the tumor was strongly positive for c-kit (CD117), showing diffuse and cytoplasmic reactivity
See this image and copyright information in PMC

References

    1. Zuckerman GR, Prakash C. Acute lower intestinal bleeding: part I: clinical presentation and diagnosis. Gastrointest Endosc. 1998;48(6):606–617. doi: 10.1016/S0016-5107(98)70043-4. - DOI - PubMed
    1. Zakaria AH, Daradkeh S. Jejunojejunal intussusception induced by a gastrointestinal stromal tumor. Case Rep Surg. 2012;2012:173680. - PMC - PubMed
    1. Sankey RE, Maatouk M, Mahmood A, Raja M. Case report: jejunal gastrointestinal stromal tumour, a rare tumour, with a challenging diagnosis and a successful treatment. J Surg Case Rep. 2015;2015:5. doi: 10.1093/jscr/rjv050. - DOI - PMC - PubMed
    1. Vasiliadis K, Kogopoulos E, Katsamakas M, Karamitsos E, Tsalikidis C, Pringos B, et al. Ileoileal intussusception induced by a gastrointestinal stromal tumor. World J Surg Oncol. 2008;6:133. doi: 10.1186/1477-7819-6-133. - DOI - PMC - PubMed
    1. Martis JJ, Rajeshwara KV, Murulya KS, Raghavendra BK, Alex KM. A rare cause of jejunojejunal intussusception in an adult. Indian J Surg. 2013;75(Suppl 1):18–20. doi: 10.1007/s12262-011-0295-5. - DOI - PMC - PubMed

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