A CASE OF GIST OF THE SMALL INTESTINE ASSOCIATED WITH GASTROINTESTINAL BLEEDING AND GENERAL PERITONITIS

Abstract

A 61-year-old man who had had anal bleeding since about the middle of October 2003 was seen at the hospital because of aggravating abdominal pain and fever which occurred on the day before. There were spontaneous pain, tenderness and muscular defense in the entire abdomen. The hemoglobin level was 5.3g/dl, showing severe anemia. Abdominal CT scan showed a tumor about 7cm in diameter continuing to the small intestine. Emergency operation was carried out with a diagnosis of gastrointestinal bleeding and peritonitis relating with the tumor. There was about 100ml of pus contamination in the abdominal cavity and peritonitis was identified. A tumor about 7cm in diameter was confirmed on the mesentery side of the small intestine 120cm distal from the Treitz' ligament. The tumor was composed of solid and cystic parts, the solid part continued to the intestine with bleeding and the cystic part perforated. The small intestine by about 20cm in length including the tumor was excised. The histopathological diagnosis was moderately malignant gastrointestinal stromal tumor (GIST) of the small intestine.
GIST of the small intestine is primarily rare, especially GIST of the small intestine associated with gastrointestinal bleeding and peritonitis. This very rare case is reported here.