A case of gist of the small intestine with repeated intestinal obstruction due to intussusception

Abstract

A 59-year-old woman visited the emergency clinic in our hospital because of abdominal pain and vomiting was admitted to the hospital with a diagnosis of intestinal obstruction on May 3, 2007. Symptomatic remission was attained by placing a gastric tube, and the tube was removed. Intestinal obstruction recurred on the evening of May 9, so that a long tube was inserted. The tip of the tube reached to the ascending colon in a few days and her clinical course was observed with clamp. However intestinal obstruction recurred again. Adhesive intestinal obstruction or intestinal obstruction due to a small bowel tumor was diagnosed, and surgery was carried out on May 17. It disclosed an invagination of the ileum ranging 20cm in length at a portion about 100cm proximal to the terminal ileum which was led by a tumor. Partial resection of the small intestine including the tumor was thus performed. Histologically proliferation of oval-shaped or short spindle-shaped mesenchymal cells was noted. Immunological staining was done, and gastrointestinal stromal tumor (GIST) was resultantly diagnosed. The patient has been free from recurrence and is strictly followed in the clinic, as of 11 months after the operation.
In the treatment of intestinal obstruction of unknown origin, a possibility of a small bowel tumor such as a GIST must be kept in mind.