title: Jejunal GIST causing acute massive gastrointestinal bleeding: role of multidetector row helical CT in the preoperative diagnosis and management.
abstract: In this report, we describe a 34-year-old man with a jejunal gastrointestinal stromal tumour (GIST) accompanied by an unusual severe haemorrhage. Because oesophagogastroduodenoscopy proved inconclusive in determining the source of the bleeding and also because of gradually dropping haemoglobin levels and persistence of the melena not allowing colonic preparation, colonoscopy was cancelled and a mesenteric angio-computed tomography (angio-CT) was deemed necessary. The results of this analysis showed a 5-cm heterogeneous mass located in the jejunal loop surrounded by abnormal arterial structures. This multidetector computed tomography (MDCT) appearance was highly suggestive of GIST. The patient then underwent an urgent laparotomy and, peroperative findings being compatible with angio-CT descriptions, a small-bowel resection was performed. The results of the histopathological examination confirmed the diagnosis of GIST. Angio-CT helps define the size of GIST as well as its range and location and can be used as the primary routine test for patients suffering from lower-GI bleeding.
authors.affiliation: Department A of General Surgery, Charles-Nicole's Hospital, Boulevard 9-Avril-1938, 1006 Tunis, Tunisia. samidaldoul@yahoo.fr
authors.forename: Sami
authors.initials: S
authors.lastname: Daldoul
authors.forename: Amir
authors.initials: A
authors.lastname: Moussi
authors.forename: Wissem
authors.initials: W
authors.lastname: Triki
authors.forename: Rym Bennaceur
authors.initials: RB
authors.lastname: Baraket
authors.forename: Abdeljelil
authors.initials: A
authors.lastname: Zaouche
mesh_terms: D000208:Acute Disease; D000328:Adult; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000209:etiology*; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007580:Jejunal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D036542:Tomography, Spiral Computed