Related Experiment Video
Updated: Aug 11, 2025
10:52
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
5.3K
An Unexpected GIST Causing Life-Threatening Bleeding after an Elective Hernia Repair
Athary Saleem1, Fatemah Husain1, Reem Boushehry1
1Department of General Surgery, Al-Adan Hospital, State of Kuwait.
Surgery Journal (New York, N.Y.)
|February 6, 2023
Summary
Gastrointestinal stromal tumors (GISTs) can present unexpectedly with severe bleeding, even in asymptomatic patients. This case highlights a large GIST causing sudden hematemesis post-hernia surgery.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Gastrointestinal Pathology
Background:
- Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the alimentary tract.
- GISTs often manifest with gastrointestinal bleeding.
- They can present with variable sizes and complications like obstruction or pain.
Observation:
- A 53-year-old male, asymptomatic for GI symptoms, underwent elective inguinal hernia repair.
- Post-operatively, the patient experienced severe, hemodynamically compromising hematemesis.
- Upper endoscopy revealed a bleeding gastric lesion, which proved difficult to manage endoscopically.
Findings:
- Emergency laparotomy revealed a large, fungating gastric mass with peritoneal deposits.
- Histopathology confirmed a high-grade (G2) GIST.
- The unexpected GIST presentation occurred immediately after routine hernia surgery.
Implications:
- GISTs can grow asymptomatically to significant sizes before clinical manifestation.
- Sudden, severe bleeding is a potential complication of GISTs, irrespective of prior symptoms.
- This case underscores the importance of considering GISTs in patients with unexplained GI bleeding, even post-operatively.
Related Concept Videos
01:28Esophageal Varices-II: Clinical Features and Management
113
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
113
01:22Aneurysm IV: Nursing Management
15
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
15
01:28Esophageal Perforation-II: Clinical Manifestations and Management
117
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:
Clinical Manifestations:
117
01:26Aneurysm III: Interprofessional Care
16
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
16
01:24Esophageal Varices-I: Introduction
239
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...
239
01:30Venous Thrombosis IV: Nursing Management
18
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
18