Open AccessA typical presentation of a rare cause of obscure gastrointestinal bleeding
Author(s) -
Stefan Reuter,
Dominik Bettenworth,
Soeren Torge Mees,
Jörg Neumann,
Torsten Beyna,
Wolfram Domschke,
Johannes Weßling,
Hansjoerg Ullerich
Publication year - 2011
Publication title -
world journal of gastrointestinal endoscopy
Language(s) - English
Resource type - Journals
ISSN - 1948-5190
DOI - 10.4253/wjge.v3.i2.40
Subject(s) - medicine , enteroscopy , gist , colonoscopy , exploratory laparotomy , double balloon enteroscopy , gastrointestinal bleeding , melena , endoscopy , esophagogastroduodenoscopy , surgery , laparotomy , stromal tumor , capsule endoscopy , radiology , cancer , colorectal cancer , stromal cell
A 52-year-old white woman had suffered from intermittent gastrointestinal (GI) bleeding for one year. Upper GI endoscopy, colonoscopy and peroral double-balloon enteroscopy (DBE) did not detect any bleeding source, suggesting obscure GI bleeding. However, in videocapsule endoscopy a jejunal ulceration without bleeding signs was suspected and this was endoscopically confirmed by another peroral DBE. After transfusion of packed red blood cells, the patient was discharged from our hospital in good general condition. Two weeks later she was readmitted because of another episode of acute bleeding. Multi-detector row computed tomography with 3D reconstruction was performed revealing a jejunal tumor causing lower gastrointestinal bleeding. The patient underwent exploratory laparotomy with partial jejunal resection and end-to-end jejunostomy for reconstruction. Histological examination of the specimen confirmed the diagnosis of a low risk gastrointestinal stromal tumor (GIST). Nine days after surgery the patient was discharged in good health. No signs of gastrointestinal rebleeding occurred in a follow-up of eight months. We herein describe the complex presentation and course of this patient with GIST and also review the current approach to treatment.