Enterocolic fistula associated with a gastrointestinal stromal tumor

Shamsaeefar, Alireza; Hosseini, Seyed Mohammad; Motazedian, N; Razmi, T Muhammed

doi:10.4103/0019-509x.52965

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…Common symptoms tend to be vague. Infrequent presentations result from intestinal obstruction, perforation, abscess and fistula formation 3 , 6 , 13 . GISTs are capable of disrupting gastrointestinal mucosal integrity, providing a path through which colonizing bacteria gain access to the circulation.…”

Section: Discussionmentioning

confidence: 99%

“…GISTs are capable of disrupting gastrointestinal mucosal integrity, providing a path through which colonizing bacteria gain access to the circulation. Liver abscesses can develop from hematogenous dissemination of organisms in association with systemic bacteremia, local spread of bacteria from contiguous sites of infection within the peritoneal cavity and infections within the portal vasculature 13 . The treatment of hepatic abscesses usually involves drainage and intravenous antibiotics [13] , [14] , [15] .…”

Section: Discussionmentioning

confidence: 99%

“…Liver abscesses can develop from hematogenous dissemination of organisms in association with systemic bacteremia, local spread of bacteria from contiguous sites of infection within the peritoneal cavity and infections within the portal vasculature 13 . The treatment of hepatic abscesses usually involves drainage and intravenous antibiotics [13] , [14] , [15] . Several previous reports describe the association of GISTs and pyogenic liver abscesses [14] , [15] , [16] , [17] , [18] .…”

Section: Discussionmentioning

confidence: 99%

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Ileal GIST presenting with bacteremia and liver abscess: A case report and review of literature

Gorelik

Sabates

Elkbuli

et al. 2018

International Journal of Surgery Case Reports

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HighlightsSmall intestine gastrointestinal stromal tumors can infrequently present with intra-abdominal abscess, perforation, obstruction or fistula.Tumor-small intestine fistula is a rare phenomenon and occurs as a result of GISTs’ propensity to cause mucosal ulceration.Although liver metastases are common, in the rare case of a GIST complicated by gastrointestinal tract perforation, abscess or fistula, a pyogenic liver abscess is another important entity to consider.Positive blood cultures with members of the S. milleri group should prompt consideration of occult abdominal infection, perforation and gastrointestinal malignancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ileal GIST presenting with bacteremia and liver abscess: A case report and review of literature

Gorelik

Sabates

Elkbuli

et al. 2018

International Journal of Surgery Case Reports

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Early Enteral Nutrition Improves Outcomes of Open Abdomen in Gastrointestinal Fistula Patients Complicated With Severe Sepsis

Yuan

Ren

et al. 2011

Nut in Clin Prac

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Small Bowel Gastrointestinal Stromal Tumor as a Gateway for Streptococcus anginosus Causing Multiple Liver Abscesses

et al. 2020

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Gastrointestinal stromal tumors (GISTs) are the most common type of mesenchymal neoplasm of the gastrointestinal tract but consist of only 1% of all primary gastrointestinal neoplasms. Differentiated from other spindle cell tumors, GISTs are uniquely positive for CD117 expression which allows for molecular targeting therapy with imatinib mesylate (Gleevec). Clinical presentations are variable, ranging from asymptomatic to vague symptoms of abdominal pain, early satiety, abdominal distention or gastrointestinal bleeding. Very rarely, patients can present with tumor-bowel fistula and intra-abdominal abscesses. In this article, we discuss a rare presentation of a middle-aged male with multiple liver abscesses found to have a primary small bowel GIST. This patient received prompt intravenous antibiotics; however, hepatic abscesses can be easily misinterpreted as cystic hepatic metastases which can delay appropriate therapy. Streptococcus anginosus was found to be responsible for the formation of the liver abscesses visualized on computed tomography (CT) scan. Similar to Streptococcus bovis, knowledge in the literature is arising about the association between S. anginosus and gastrointestinal malignancies. This case highlights the importance of identifying concomitant primary GISTs with intra-hepatic abscesses, as these lesions can be easily misconstrued as liver metastases and consequently mismanaged. We herein emphasize that hepatic abscesses are a potential sequela of GISTs and should thus prompt further investigation for potential malignancies, if warranted, so that there is no delay in treatment of these gastrointestinal tumors.

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Enterocolic fistula associated with a gastrointestinal stromal tumor

Cited by 4 publications

References 2 publications

Ileal GIST presenting with bacteremia and liver abscess: A case report and review of literature

Ileal GIST presenting with bacteremia and liver abscess: A case report and review of literature

Early Enteral Nutrition Improves Outcomes of Open Abdomen in Gastrointestinal Fistula Patients Complicated With Severe Sepsis

Small Bowel Gastrointestinal Stromal Tumor as a Gateway for Streptococcus anginosus Causing Multiple Liver Abscesses

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