A Case of Peritonitis due to Perforation of a Gastrointestinal Stromal Tumor

Abstract

An 81-year-old woman was diagnosed with a gastrointestinal stromal tumor (GIST) with multiple liver metastases in October 2008, and treatment with imatinib was started. The disease was controlled, but in February 2011, both the primary lesion and the liver metastases grew, and ascites was seen on computed tomography (CT). Sunitinib was then given instead of imatinib ; however, it had to be stopped due to renal failure and severe diarrhea. In March 2011, the patient was admitted to our hospital with severe abdominal pain and guarding. CT showed free air in the abdominal space ; therefore, she was diagnosed with peritonitis due to perforation of the GIST, and surgery was performed. There was considerable ascites, and the tumor and tissues were adherent in the left subphrenic space. It was difficult to detect and suture the perforated gastric GIST, so only washing and drainage were performed. Oral intake was started on postoperative day 9, and she left the hospital on postoperative day 32. She was treated with imatinib regularly ; however, she died of her primary illness in October 2011. The case of a patient with peritonitis due to perforation of a gastric GIST was described. The peritonitis was controlled, and her quality of life was maintained with washing and drainage.