A Case of Small Intestinal GIST of the Extramural Growth Type Diagnosed After Bleeding Triggered by Trauma Sustained in a Traffic Accident

Abstract

A 78-year-old male was brought to our hospital because of trauma sustained in a traffic accident. On arrival he was conscious and showed no evidence of surface trauma except an abrasion on his left knee, but examination revealed tachycardia. He was urgently admitted with retrograde amnesia, for close examination and treatment. The next day, a blood test revealed a rapid decrease in hemoglobin concentration, and a contrast-enhanced CT scan of the thorax and abdomen showed a tumor measuring approximately 60 mm in the abdominal cavity and hemorrhagic ascites around the tumor and in the pelvis. Intraoperative exploration revealed an extramural tumor in the jejunum approximately 150 cm from the ligament of Treitz. The tumor was elastic and soft, and its surface capsule was lacerated and bleeding. The segment of small intestine containing the tumor was resected. The histopathological diagnosis was gastrointestinal stromal tumor. We report a case in which intra-abdominal hemorrhage due to trauma sustained in a traffic accident led to the diagnosis of GIST of the small intestine with extramural growth, together with a review of the literature.