A case of gist of the small intestine cuasing intraabdominal hemorrhage

Abstract

A 46-year-old man complaining of abdominal pain was referred to the department of surgery from the department of internal medicine in our hospital with a suspicion of an intraabdominal tumor. No abnormal findings were revealed by endoscopic study. Abdominal CT scan showed a 6cm-sized tumor with an enhancement effect in the lower abdomen and fluid in the pelvic cavity as well. The patient was operated on with a diagnosis of an intraabdominal tumor on November 22, 2004. At surgery there were bloody ascites, about 150ml, in the abdominal cavity and an outgrowing tumor in the ileum at about 210cm distant from the Treitz' ligament. We noted some clots attached to the tumor and a small amount of hemorrhage from it. Thus the tumor was determined to be the bleeding source. Partial resection of the small intestine including the tumor with end-to-end anastomosis was performed. Immunostaining resulted in positive reaction only to c-kit, and thus gastrointestinal stromal tumor (GIST) of the small intestine was diagnosed. The patient has been doing well, as of approximately 3 years after the operation.