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Related Concept Videos

Esophageal Perforation-I: Introduction01:22

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Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
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Esophageal Perforation-II: Clinical Manifestations and Management01:28

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Esophageal Varices-I: Introduction01:24

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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Murine Model of Metastatic Liver Tumors in the Setting of Ischemia Reperfusion Injury
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Spontaneous Hemoperitoneum From a Ruptured Gastrointestinal Stromal Tumor.

Jordan Shively1, Charles Ebersbacher2, William T Walsh1

  • 1General Surgery, Cleveland Clinic South Pointe Hospital, Warrensville Heights, USA.

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|August 28, 2020
PubMed
Summary

This case report details a ruptured gastrointestinal stromal tumor (GIST) causing spontaneous hemoperitoneum. Prompt surgical resection and imatinib therapy were initiated for this high-grade GIST presenting with intraperitoneal bleeding.

Keywords:
gastrointestinal stromal tumorgastrointestinal stromal tumor (gist)gistspontaneous hemoperitoneum

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Oncologic Imaging

Background:

  • Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms.
  • While often asymptomatic, GISTs can present with abdominal pain, bleeding, or obstruction.
  • Rupture of an exophytic GIST leading to hemoperitoneum is an uncommon but critical presentation.

Observation:

  • A 63-year-old female presented with epigastric pain and was found to have spontaneous hemoperitoneum on CT scan.
  • Diagnostic laparoscopy revealed a ruptured, necrotic, and actively bleeding pedunculated mass on the posterior greater curvature of the stomach.
  • The mass was identified as a high-grade GIST with spindle cells and a high mitotic rate.

Findings:

  • Surgical resection with negative margins was achieved via laparotomy.
  • The patient received imatinib therapy for a minimum of three years due to tumor rupture.
  • Histopathology confirmed a pT3N0M0 high-grade GIST with spindle cell morphology.

Implications:

  • Ruptured GISTs present a higher risk of tumor dissemination and recurrence.
  • Early diagnosis and surgical management are crucial for improved outcomes.
  • Adjuvant imatinib therapy is indicated for high-risk GISTs, especially after rupture.