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A bleeding GIST in pandemic times, a cooperative approach to a delayed complication, a case report
William G Aguayo1, F Xavier Moyon1, Gabriel A Molina2
1Hospital General San Francisco IESS, Quito, Ecuador.
Insights
Delayed treatment for bleeding gastric gastrointestinal stromal tumors (GISTs) due to the Covid-19 pandemic can lead to severe complications. Prompt surgical intervention is crucial for positive patient outcomes, even amidst healthcare challenges.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Infectious Disease Epidemiology
Background:
- Upper gastrointestinal bleeding is a critical manifestation of gastric gastrointestinal stromal tumors (GISTs), often indicating a poor prognosis.
- The Covid-19 pandemic exacerbated healthcare challenges, leading to delayed surgical treatments, increased complications, and reduced patient access to care.
- Ecuador faced significant limitations, with the pandemic's full impact on patient outcomes still under investigation.
Introduction:
Upper gastrointestinal bleeding is one of the major manifestations of the stomach's gastrointestinal stromal tumors; when gastric GISTs bleed, they are associated with a poor prognosis and must be treated promptly to avoid dangerous complications. A worrisome side effect of the Covid-19 pandemic is the delay in surgical treatment for seriously ill patients, a rise in surgical complications due to delayed care, lack of access to the healthcare system, and patients' hesitancy to seek care due to fear of the virus. In Ecuador, where limitations were present even in the absence of a pandemic, we are yet to fully know the full extent of the damage this pandemic has caused to ourselves and our patients.
Presentation Of Case:
We present the case of a 51-year-old female; she presented with upper gastrointestinal bleeding, and a gastric GIST was diagnosed. Due to the size and the symptoms, surgery was planned. Nonetheless, as Ecuador was hit hard by the Covid-19 pandemic to cope with the respiratory patients, surgeries were delayed or canceled. Our patient surgery was delayed for five months until she presented with severe gastrointestinal bleeding that required urgent action and care. Thankfully, she completely recovered.
Discussion And Conclusions:
This case is an example of the many complications we expect due to the pandemic; delay in treatment leads to troublesome complications. In these emergencies, time is of the essence, and surgical services must rise to the challenge; in a particular way, this case also proves that if there are the necessary tools to enhance the patient's recovery, we should hesitate to use them. Complete resection of the gastric GIST in a prompt matter must be done to avoid these potentially deadly complications.
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