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Spontaneous perforation of jejunal gastrointestinal stromal tumor: A case report.
Int J Surg Case Rep. 2020 Jun 27; 73:31-34.IJ

Abstract

INTRODUCTION

The incidence of small bowel tumors is comparatively rare when compared to colonic tumors. They comprise less than 10% of all gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract; however it accounts for less than 1% of all gastrointestinal tumors.

AIM

To report a rare case of jejunal gastrointestinal stromal tumor presenting as a life-threatening emergency in a young adult male who was treated in the General Surgery department in the Jordanian Royal Medical Services (JRMS), Amman, Jordan.

PRESENTED CASE

We report a 59-year-old male who presented to our emergency department with severe generalized abdominal pain. The patient was in a hypovolemic shock. Abdominal examination revealed a massively distended, tender abdomen. Abdomenal CT scan with IV contrast showed significant fat stranding around the jejunum associated with pneumoperitoneum and free fluid. Exploratory laparotomy was emergently performed, revealing diffuse peritonitis secondary to perforated small bowel tumor. En bloc resection was performed. Histopathologic examination confirmed the presence of malignant gastrointestinal stromal tumor of the jejunum with R0 clearance.

DISCUSSION

Gastrointestinal stromal tumors are relatively rare and the jejunum is the least affected among other parts of the GI tract. The majority of ruptured GISTs occur spontaneously, and are located in the stomach and small bowel. Most ruptured GISTs are associated with dismal prognosis.

CONCLUSION

A jejunal gastrointestinal stromal tumor can rarely present with spontaneous perforation. However, it is important to highlight this condition, as early emergency intervention constitutes the key to a good outcome.

Authors+Show Affiliations

Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan. Electronic address: alsweaiti@gmail.com.Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan. Electronic address: Mhq9511@yahoo.com.Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan. Electronic address: Mohammad.aldoud@yahoo.com.Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan. Electronic address: Bdouralaa111@gmail.com.Department of Radiology, Jordanian Royal Medical Services (JRMS), Amman, Jordan. Electronic address: dr.alnizami@hotmail.com.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32629218

Citation

Al-Swaiti, Ghassan T., et al. "Spontaneous Perforation of Jejunal Gastrointestinal Stromal Tumor: a Case Report." International Journal of Surgery Case Reports, vol. 73, 2020, pp. 31-34.
Al-Swaiti GT, Al-Qudah MH, Al-Doud MA, et al. Spontaneous perforation of jejunal gastrointestinal stromal tumor: A case report. Int J Surg Case Rep. 2020;73:31-34.
Al-Swaiti, G. T., Al-Qudah, M. H., Al-Doud, M. A., Al-Bdour, A. R., & Al-Nizami, W. (2020). Spontaneous perforation of jejunal gastrointestinal stromal tumor: A case report. International Journal of Surgery Case Reports, 73, 31-34. https://doi.org/10.1016/j.ijscr.2020.06.088
Al-Swaiti GT, et al. Spontaneous Perforation of Jejunal Gastrointestinal Stromal Tumor: a Case Report. Int J Surg Case Rep. 2020 Jun 27;73:31-34. PubMed PMID: 32629218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spontaneous perforation of jejunal gastrointestinal stromal tumor: A case report. AU - Al-Swaiti,Ghassan T, AU - Al-Qudah,Mohammad H, AU - Al-Doud,Mohammad A, AU - Al-Bdour,Alaa R, AU - Al-Nizami,Walid, Y1 - 2020/06/27/ PY - 2020/05/21/received PY - 2020/06/08/revised PY - 2020/06/20/accepted PY - 2020/7/7/pubmed PY - 2020/7/7/medline PY - 2020/7/7/entrez KW - Acute abdomen KW - Gastrointestinal stromal tumor KW - Perforation SP - 31 EP - 34 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 73 N2 - INTRODUCTION: The incidence of small bowel tumors is comparatively rare when compared to colonic tumors. They comprise less than 10% of all gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract; however it accounts for less than 1% of all gastrointestinal tumors. AIM: To report a rare case of jejunal gastrointestinal stromal tumor presenting as a life-threatening emergency in a young adult male who was treated in the General Surgery department in the Jordanian Royal Medical Services (JRMS), Amman, Jordan. PRESENTED CASE: We report a 59-year-old male who presented to our emergency department with severe generalized abdominal pain. The patient was in a hypovolemic shock. Abdominal examination revealed a massively distended, tender abdomen. Abdomenal CT scan with IV contrast showed significant fat stranding around the jejunum associated with pneumoperitoneum and free fluid. Exploratory laparotomy was emergently performed, revealing diffuse peritonitis secondary to perforated small bowel tumor. En bloc resection was performed. Histopathologic examination confirmed the presence of malignant gastrointestinal stromal tumor of the jejunum with R0 clearance. DISCUSSION: Gastrointestinal stromal tumors are relatively rare and the jejunum is the least affected among other parts of the GI tract. The majority of ruptured GISTs occur spontaneously, and are located in the stomach and small bowel. Most ruptured GISTs are associated with dismal prognosis. CONCLUSION: A jejunal gastrointestinal stromal tumor can rarely present with spontaneous perforation. However, it is important to highlight this condition, as early emergency intervention constitutes the key to a good outcome. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/32629218/Spontaneous_perforation_of_jejunal_gastrointestinal_stromal_tumor:_A_case_report L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(20)30491-0 DB - PRIME DP - Unbound Medicine ER -
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