Acute Abdomen Presenting with Spontaneous Small Bowel Perforation Due to a Gastrointestinal Stromal Tumor: A Case Report
Erkan Somuncu, İsmail Demiryilmaz, Mehmet Soyturk, Ferda Cimen, Orhan Cimen, Huseyin Eken, Kemal Peker
Department of General Surgery, Erzincan University Mengücek Gazi and Training Hospital, Erzincan, Turkey
Med Sci Case Rep 2015; 2:64-68
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract. GISTs are usually asymptomatic and diagnosis is usually incidental. GIST perforation is a particularly rare presentation clinically.
CASE REPORT: We report the case of a 60-year-old Turkish woman presenting with acute abdomen approximately 9 months ago. The accurate diagnosis was established by computed tomography (CT). We performed a complete resection of the tumor with emergency laparotomy. The patient was discharged without any problems after 5 days.
CONCLUSIONS: GISTs are the most common mesenchymal tumors. Several radiologic modalities, such as computed tomography, barium examination, and angiography, are performed. Spontaneous GIST perforation is an unclear clinical presentation with a variety of possible causes. Complete surgical excision of the tumor should be the initial therapy for primary resectable GISTs with no metastasis. GISTs commonly express CD117(KIT) and often CD34. Prognostic factors are age at presentation, anatomic location, tumor size (especially important), histo-morphology, immuno-histochemistry, and molecular genetics.
Spontaneous perforation of GIST is rare and can be difficult to diagnose.
Keywords: Spontaneous Bowel Perforation, mesenchymal tumor, GIST