A Case of Emergency Operation for a Giant Jejunal GIST

Abstract

A 73–year–old man was admitted to our ER with sharp abdominal pain. Physical examination revealed abdominal tenderness in the left lower abdomen. Abdominal contrast–enhanced computed tomography showed a giant (14 cm) outgrowing jejunal tumor, not yet ruptured. However, the inflammatory response in the laboratory data was high which was associated with limited peritonitis. The patient was therefore diagnosed as having a jejunal tumor, suspected as being a gastrointestinal stromal tumor (GIST) with inflammation, judged to be at risk of rupture. GIST is a disease related to the prognosis unless complete resection is possible. Emergency surgery was performed because of the oncological emergency. The large tumor was squeezing the pancreas. The jejunum was resected together with the large tumor and a distal pancreatectomy was performed. The immunohistological examination led to the diagnosis of a jejunal GIST, not yet ruptured. The patient was prescibed imatinib 400 mg per day and had to be followed up carefully.