Hemoperitoneum Caused by a Ruptured GIST Located in the Posterior Gastric Wall Managed by Endoscopic Diagnosis and Laparoscopic Treatment

Costi, Renato; Bian, Alban Le; Creuzé, Nicolas; Prévôt, Sophie; Cauchy, François; Violi, Vincenzo; Smadja, Claude

doi:10.1097/sle.0b013e318231998b

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…The presence of a bleeding, ruptured gastric mass of uncertain nature may result in a challenging situation for the surgeon, who is forced to perform a gastric resection without knowing the exact nature of the tumor and hence the entity of gastric resection required, or whether a lymphadenectomy is needed [3] .…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous hemoperitoneum as a rare presentation of gastric lesions: Two case reports

Almeida

Lima

Pinto

et al. 2022

International Journal of Surgery Case Reports

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Introduction Spontaneous hemoperitoneum is a rare but life-threatening condition. Clinical presentation is usually nonspecific. The aim of this report is to document a rare clinical presentation of two different intramural stomach tumors. Clinical cases A 40-year-old patient with 24 h epigastric pain was admitted to the emergency, pale, with signs of peritoneal irritation. Computed tomography showed an hemoperitoneum with active bleeding in the posterior wall of the stomach. A wedge resection was performed. Histological report revealed a plexiform fibromyxoma (PF). The second case presents a 79-year-old patient with 24 h abdominal pain, fullness and dizziness, pale and with signs of peritoneal irritation. A voluminous exophytic lesion on gastric wall with active bleeding was diagnosed. Wedge resection was performed and histological report demonstrated a gastrointestinal stromal tumor (GIST). Discussion Imaging plays a role in the diagnosis of spontaneous hemoperitoneum, in elucidating a cause and detecting active hemorrhage. Tumor hemorrhage may be the first presentation of an underlying mass. The presence of a bleeding gastric mass of uncertain nature may result in a challenging situation for the surgeon, who is forced to perform a gastric resection without knowing the exact nature of the tumor and hence the extent of gastric resection required. To our knowledge, our case is the first of PF presenting as hemoperitoneum. Hemoperitoneum is rare as first presentation of GIST, with few cases reported in literature. Conclusion We report two extremely rare cases of spontaneous hemoperitoneum as first presentation of gastric tumor. For the diagnosis a high level of suspicion is required.

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Section: Discussionmentioning

confidence: 99%

“…Hemoperitoneum is a rare complication of gastric lesions. Due to its rarity, the diagnosis of this lesions as the cause of hemoperitoneum may be challenging [3] .…”

Section: Introductionmentioning

confidence: 99%

Spontaneous hemoperitoneum as a rare presentation of gastric lesions: Two case reports

Almeida

Lima

Pinto

et al. 2022

International Journal of Surgery Case Reports

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“…[5][6][7][8][9][10] Many patients with ruptured gastric GIST often present with non-specific complaints such as acute abdominal pain and progressive lowering of haemoglobin. [5][6][7][8][9][10] In our two cases, there was also anaemia and abdominal pain. Nonetheless, only the first case presented with low blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Gastrointestinal Stromal Tumour Presenting Uncommonly as Intraperitoneal Rupture in Patients Prescribed Warfarin

Nung¹,

Wong²,

Lee³

et al. 2016

Hong Kong J Radiol

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Gastrointestinal stromal tumour (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Common presentations of GIST include early satiety, indigestion, bloating, vague abdominal pain, and gastrointestinal bleeding. Intraperitoneal rupture is an uncommon presentation of GIST. We have encountered two patients prescribed warfarin, who presented with intraperitoneal haemorrhage as their initial presentation of gastric GIST. Computed tomography (CT) revealed a submucosal gastric mass with intralesional and intraperitoneal haemorrhage. The diagnosis of ruptured GIST was made based on CT findings. These two cases are, to the best of our knowledge, the first two cases with rupture and intraperitoneal haemorrhage as the initial presentation of gastric GIST while on warfarin.

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“…The CD117-DOG1+ patients can be treated with tyrosine kinase inhibitors like the C-KIT positive individuals. As to surgical approach, exploratory laparotomy was chosen, but some authors (9) described a case of hemoperitoneum secondary to gastric GIST treated by laparoscopy and vertical gastrectomy, with no intercurrent events, and surgeries that started by laparoscopy and were converted to laparotomy, due to intense bleeding and hemodynamic instability (10) .…”

Section: Discussionmentioning

confidence: 99%

Hemoperitôneo secundário a GIST gástrico c-KIT negativo e anticorpo anti-DOG1 positivo

Epstein

Pasquetti

Costa

et al. 2012

Einstein (São Paulo)

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Although relatively rare, the gastrointestinal stromal tumors comprise most mesenchymal tumors of the digestive tract and account for 5% of all sarcomas. The most common symptoms are pain, gastrointestinal bleeding and palpable mass. This study reported the case of a young patient who developed hemoperitoneum due to gastric neoplasm rupture and required urgent surgical treatment. Pathology and immunohistochemistry analysis showed an epidemiologically rare case: epithelioid and c-KIT negative tumor.Keywords: Gastrointestinal stromal tumors; Gastrointestinal hemorrhage/diagnosis; Gastrectomy; Gastrointestinal neoplasms; Endoscopy; Case reports RESUMOOs tumores estromais do trato gastrintestinal, embora relativamente raros, compreendem a maioria dos tumores mesenquimais do trato digestivo e constituem 5% de todos os sarcomas. Quanto à apresentação clínica, os sintomas mais comuns são dor, hemorragia digestiva e massa palpável. Este trabalho relatou o caso de um paciente jovem que desenvolveu hemoperitôneo por ruptura de neoplasia gástrica e necessitou de tratamento cirúrgico de urgência. A análise patológica e imunoistoquímica revelou tratar-se de um caso raro epidemiologicamente: tipo celular epitelioide e c-KIT negativo.

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Hemoperitoneum Caused by a Ruptured GIST Located in the Posterior Gastric Wall Managed by Endoscopic Diagnosis and Laparoscopic Treatment

Cited by 13 publications

References 24 publications

Spontaneous hemoperitoneum as a rare presentation of gastric lesions: Two case reports

Spontaneous hemoperitoneum as a rare presentation of gastric lesions: Two case reports

Two Cases of Gastrointestinal Stromal Tumour Presenting Uncommonly as Intraperitoneal Rupture in Patients Prescribed Warfarin

Hemoperitôneo secundário a GIST gástrico c-KIT negativo e anticorpo anti-DOG1 positivo

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