title: Development of enterohepatic fistula after embolization in ileal gastrointestinal stromal tumor: a case report.
abstract: Gastrointestinal stromal tumor (GIST) is a rare mesenchymal tumor of the gastrointestinal tract that has been associated with the formation of fistulas to adjacent organs in few case reports. However, GIST with enterohepatic fistula has not been reported. Here we report the case of an enterohepatic fistula that occurred after embolization of a liver mass originating in the distal ileum. An 87-year-old woman was hospitalized for melena. On initial conventional endoscopy, a bleeding focus in the gastrointestinal tract was not found. Because of massive hematochezia, enteroscopy was performed through the anus. A protruding, ulcerative mass was found in the distal ileum that was suspected to be the source of the bleeding; a biopsy sample was taken. Electrocoagulation was not successful in controlling the bleeding; therefore, embolization was performed. After embolization, the patient developed a high fever and severe abdominal tenderness with rebound tenderness. Follow-up abdominopelvic computed tomography revealed an enterohepatic fistula between the liver and distal ileum. The fistula was treated surgically by segmental resection of the distal ileum and unlooping of the liver mass.
authors.affiliation: Yun Ho Lee, Ja Seol Koo, Chang Ho Jung, Sang Yoon Chung, Jae Joong Lee, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Rok Seon Choung, Sang Woo Lee, Jai Hyun Choi, Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do 425-707, South Korea.
authors.forename: Yun Ho
authors.initials: YH
authors.lastname: Lee
authors.forename: Ja Seol
authors.initials: JS
authors.lastname: Koo
authors.forename: Chang Ho
authors.initials: CH
authors.lastname: Jung
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Chung
authors.forename: Jae Joong
authors.initials: JJ
authors.lastname: Lee
authors.forename: Seung Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Hyun
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Jung
authors.forename: Rok Seon
authors.initials: RS
authors.lastname: Choung
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Jai Hyun
authors.initials: JH
authors.lastname: Choi
mesh_terms: D000369:Aged, 80 and over; D001706:Biopsy; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000556:secondary / Q000628:therapy*; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary / Q000628:therapy*; D009361:Neoplasm Invasiveness; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Bleeding; Enterohepatic fistula; Gastrointestinal stromal tumor; Ileal gastrointestinal stromal tumor; Therapeutic embolization