Case report and literature review: patient with gastroduodenal intussusception due to the gastrointestinal stromal tumor of the lesser curvature of the gastric body

Đokić, Mihajlo; Novak, Janez; Petrič, Miha; Ranković, Branislava; Štabuc, Miha; Trotovšek, Blaž

doi:10.1186/s12893-019-0608-3

Cited by 14 publications

(16 citation statements)

References 23 publications

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“…GIST tumors are the most common cause of gastroduodenal intussusception. At 23 years, this patient is younger than the other previously reported cases of GISTs causing gastroduodenal intussusception (Mean age 64.5, median age 65 and range 29–95 years) [14] , [15] .…”

Section: Discussionmentioning

confidence: 59%

“…Gastroduodenal intussusceptions secondary to GISTs present a diagnostic dilemma due to their widely unspecific and variable presentation. Their Presentation may range from acute, subacute to chronic symptoms with clinical features such as intermittent mild to severe epigastric pain, nausea, vomiting, abdominal tenderness, palpable epigastric mass, weight loss plus gastrointestinal bleeding with anemia secondary to mucosal ulceration [14] , [15] . This patient had a chronic history of all these features with intermittent episodes of vomiting and increased epigastric pain which might be explained by possible recurrent, spontaneously reducible intussusceptions.…”

Section: Discussionmentioning

confidence: 99%

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Gastroduodenal intussusception as a rare cause of pancreatitis in a young female Ugandan: A case report

Okello

Derick

Ocama

2021

International Journal of Surgery Case Reports

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Introduction and importance Gastroduodenal intussusceptions are rare and usually secondary to gastric lesions acting as the lead point. Gastrointestinal stromal tumors (GISTs) commonly occur in the stomach (40–60%). Other gastric tumors include; adenocarcinomas, leiomyomas, lymphomas among others. When gastric tumors act as lead points in gastroduodenal intussusception, pancreatitis may arise due to compression of the ampulla of Vater or pancreatic head. Gastroduodenal intussusception may mimic other inflammatory upper gastrointestinal conditions leading to delays in early diagnosis and timely intervention. Case presentation A twenty three year old female with gastroduodenal intussusception secondary to a gastric body GIST with associated pancreatitis. This gastroduodenal mass was initially diagnosed as a pancreatic head echo-complex mass by ultrasound. Confirmatory preoperative diagnosis was made after doing contrasted abdominal computed tomography (CT) scan and upper gastrointestinal endoscopy. Open gastric wedge resection was done. Patient had uneventful recovery and was discharged on the fifth postoperative day. Clinical discussion Gastroduodenal intussusceptions have non-specific clinical features that may lead to delays in making the correct diagnosis. CT scan is a good imaging modality for diagnosing this condition but access is limited in low resource settings. Resection of the organic cause after reducing the intussusception leads to resolution of the symptoms caused by the intussusception, the GIST and the resultant pancreatitis. Conclusion Gastroduodenal intussusception is rare and may present with nonspecific clinical features. Pancreatitis may arise due to the compression effects on the ampulla of Vater or pancreatic head. A high index of suspicion is key in making a timely diagnosis.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Gastroduodenal intussusception as a rare cause of pancreatitis in a young female Ugandan: A case report

Okello

Derick

Ocama

2021

International Journal of Surgery Case Reports

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“…All patients underwent surgical resection. 6 Our patient developed acute pancreatitis, which is an exceedingly peculiar complication of gastroduodenal intussusception. This condition was believed to be triggered by pancreatic duct distortion or compression secondary to the duodenal wall traction or direct obstruction of the pancreatic duct orifice by the intussusceptum.…”

Section: Discussionmentioning

confidence: 72%

Gastroduodenal intussusception of a gastrointestinal stromal tumor: a rare cause of acute pancreatitis

et al. 2022

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Gastrointestinal stromal tumor (GIST) accounts for approximately 1% of all gastrointestinal tract neoplasms. 1 GIST usually presents as an incidental gastric subepithelial lesion during upper endoscopy or abdominal radiologic studies. In symptomatic cases, abdominal pain and gastrointestinal bleeding are common manifestations. Gastrointestinal obstruction is a less frequent presentation, occurring in only 10-30% of patients, 2 while gastroduodenal intussusception and acute pancreatitis are extremely unusual presentations of gastric GIST. This report presents the case of a patient diagnosed with gastric GIST complicated by gastroduodenal intussusception, resulting in acute pancreatitis. CASE REPORTA 55-year-old man presented with worsening epigastric pain and vomiting for 10 days. He reported intermittent abdominal pain for 10 months prior to presentation. Abdominal examination revealed tenderness at the epigastrium. His serum amylase level was 320 U/L, compatible with acute pancreatitis. Abdominal computed tomography (CT) revealed a 4 × 4.7 cm well-defined hyperdense mass in the 2 nd part of the duodenum, compressing the pancreatic head, edematous pancreatic parenchyma, peripancreatic fat stranding, and pancreatic duct dilatation (Fig. 1A, B). Esophagogastroduodenoscopy was significant for abnormal torsion of gastric folds that originated from the gastric fundus, coursed along the lesser curvature, and invaginated into the pyloric canal, thereby blocking the passage of the scope into the duodenal bulb (Fig.

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“…, early satiety and bloating), unless they ulcerate, bleed, or grow large enough to cause pain or obstruction. Conceivably, gastroduodenal intussusception caused by GIST most commonly presents with nonspecific symptoms of acute or intermittent abdominal pain with vomiting lasting from days to several months[ 8 ]. By reviewing the relevant literature, we found 41 cases of gastroduodenal intussusception within the past 20 years (Table 2 )[ 9 - 44 ].…”

Section: Discussionmentioning

confidence: 99%

Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor: A case report and review of the literature

Hsieh¹,

Hsu²,

Lee³

et al. 2021

WJCC

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BACKGROUND Gastric gastrointestinal stromal tumor (GIST) is the most common etiology of gastroduodenal intussusception. Although gastroduodenal intussusception caused by gastric GIST is mostly treated by surgical resection, the first case of gastroduodenal intussusception caused by gastric GIST was treated by endoscopic submucosal dissection (ESD) in Japan in 2017. CASE SUMMARY An 84-year-old woman presented with symptoms of postprandial fullness with nausea and occasional vomiting for a month. Initially, she visited a local clinic for help, where abdominal sonography revealed a space-occupying lesion around the liver, so she was referred to our hospital for further confirmation. Abdominal sonography was repeated, which revealed a mass with an alternating concentric echogenic lesion. Esophagogastroduodenoscopy (EGD) was performed under the initial impression of gastric cancer with central necrosis and showed a tortuous distortion of gastric folds down from the lesser curvature side to the duodenal bulb with stenosis of the gastric outlet. EGD was barely passed through to the 2nd portion of the duodenum and a friable ulcerated mass was found. Several differential diagnoses were suspected, including gastroduodenal intussusception, gastric cancer invasion to the duodenum, or pancreatic cancer with adherence to the gastric antrum and duodenum. Abdominal computed tomography for further evaluation was arranged and showed gastroduodenal intussusception with a long stalk polypoid mass 5.9 cm in the duodenal bulb. Under the impression of gastroduodenal intussusception, ESD was performed at the base of the gastroduodenal intussusception; unfortunately, a gastric perforation was found after complete resection was accomplished, so gastrorrhaphy was performed for the perforation and retrieval of the huge polypoid lesion. The gastric tumor was pathologically proved to be a GIST. After the operation, there was no digestive disturbance and the patient was discharged uneventfully on the 10th day following the operation. CONCLUSION We present the second case of gastroduodenal intussusception caused by GIST treated by ESD. It is also the first case report of gastroduodenal intussusception by GIST in Taiwan, and endoscopic reduction or resection is an alternative treatment for elderly patients who are not candidates for surgery.

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Case report and literature review: patient with gastroduodenal intussusception due to the gastrointestinal stromal tumor of the lesser curvature of the gastric body

Cited by 14 publications

References 23 publications

Gastroduodenal intussusception as a rare cause of pancreatitis in a young female Ugandan: A case report

Gastroduodenal intussusception as a rare cause of pancreatitis in a young female Ugandan: A case report

Gastroduodenal intussusception of a gastrointestinal stromal tumor: a rare cause of acute pancreatitis

Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor: A case report and review of the literature

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