2009
DOI: 10.1177/030089160909500216
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Spontaneous Rupture of Giant Gastric GIST Presenting as Hemoperitoneum and Mimicking Cavernous Liver Angioma

Abstract: Spontaneous rupture of gastrointestinal stromal tumor (GIST) with hemoperitoneum is an extremely rare clinical presentation of this mesenchymal tumor. We report the unusual case of a 68-year-old man who was admitted to the hospital with abdominal pain. While waiting for the results of his laboratory tests the patient became pale and tachycardic and his abdomen distended with generalized rebound tenderness. A CT scan suggested rupture of a cavernous angioma of the liver and the patient was brought to the operat… Show more

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Cited by 12 publications
(8 citation statements)
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“…In addition to tumour size, mitotic rate and tumour location, tumour rupture is thought to be a prognostic factor for the outcome of patients with GIST. The only data available thus far, however, stem exclusively from case reports11–24. Extraluminal bleeding to the abdominal cavity is reported less often, and results in haemoperitoneum or acute peritonitis requiring urgent treatment.…”
Section: Discussionmentioning
confidence: 99%
“…In addition to tumour size, mitotic rate and tumour location, tumour rupture is thought to be a prognostic factor for the outcome of patients with GIST. The only data available thus far, however, stem exclusively from case reports11–24. Extraluminal bleeding to the abdominal cavity is reported less often, and results in haemoperitoneum or acute peritonitis requiring urgent treatment.…”
Section: Discussionmentioning
confidence: 99%
“…[10][11][12][13][14][15][16][17][18][19][20][21] In all cases, the tumor size was >5 cm, 12 of the 15 patients were older than 60 years, and the male-tofemale ratio was 2 : 1. Seven GISTs arose from the stomach 10,11,13,15,19,21 and four from the small intestine. [12][13][14]20 One case each originated from the mesocolon, 16 esophagus, 17 and greater omentum.…”
Section: Discussionmentioning
confidence: 99%
“…In fact, biopsy is not essential for the diagnosis of GISTs, and the endoscopic view of a submucosal mass, possibly ulcerating the overlapping mucosa, is diagnostic of gastric GIST. 24 As patients presenting hemoperitoneum associated to gastric GISTs are usually hemodynamically stable, 6,7,[9][10][11]13 as in the reported case, we believe that a preoperative endoscopy should be performed whenever possible to plan the most appropriate laparoscopic procedure. Interestingly, endoscopy (associated to endoscopic ultrasound) allowed for the identification of gastric GIST is the only case where a correct diagnosis was achieved preoperatively.…”
Section: Discussionmentioning
confidence: 87%
“…[6][7][8][9][10][11][12][13] GIST-associated hemoperitoneum has also been reported to be responsible for mortality. 6 The diagnosis and management of gastric GIST associated to hemoperitoneum may be challenging, because extragastric bleeding is mostly spontaneous, 6,[9][10][11][12][13] and traditional imaging is not effective in identifying a bleeding GIST in an emergency setting. In the reported case, CT scan identified a round gastric mass with an isodense external layer and hypodense core ( Fig.…”
Section: Discussionmentioning
confidence: 99%
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