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Gastrointestinal stromal tumour presenting acutely as gastroduodenal intussusception
A Gyedu1, S B Reich, P E Hoyte-Williams
1Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana. drgyedu@gmail.com
Introduction:
Gastrointestinal stromal tumours (GISTs) are uncommon tumours of the gastrointestinal (GI) tract. We report a case of a gastric GIST that presented acutely as a gastroduodenal intussusception.
Case Presentation:
A 59-year-old woman presented with a week's history of vomiting anything she swallowed. Physical examination revealed a mildly tender abdomen without guarding or rebound tenderness. An epigastric mass was, however, palpated. Abdominal ultrasonography suggested an intussusception. At laparotomy, a tumour on the anterior wall of the stomach causing intussusception of the stomach into the duodenum was found. After reducing the intussusception, a wedge resection of the tumour was performed, which proved to be a GIST.
Discussion:
GISTs represent a rare group of neoplasms of the GI tract. Gastric intussusception is a rarely documented condition. Symptoms range from intermittent epigastric pain to sudden onsets of severe pain with vomiting and shock. Pre-operative diagnosis can be difficult and diagnosis cannot be confirmed until surgery. The treatment of choice for localised gastric GIST is surgical resection.
Conclusion:
Although gastroduodenal intussusception, particularly secondary to a GIST, is uncommon, clinicians need to have a high index of suspicion in acutely vomiting patients, especially if they have experienced similar symptoms intermittently in the immediate past.
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