title: A jejunal GIST presenting with obscure gastrointestinal bleeding and small bowel obstruction secondary to intussusception.
abstract: A 68-year-old man with episodes of overt obscure gastrointestinal (GI) bleeding was investigated with multiple upper and lower GI endoscopies, CT enterography and capsule endoscopy, but no cause was found. He then presented acutely with small bowel obstruction. A laparotomy revealed complete small bowel obstruction secondary to jejunal intussusception over a 4 cm intraluminal polyp. Following resection and primary anastomosis, histology revealed that the polyp was a GI stromal tumour (GIST). This is an exceptionally uncommon presentation of a rare tumour. It is surprising that this tumour was not detected by CT enterography and not seen on capsule endoscopy. Immunohistochemistry and mutation analysis of the GIST suggested that it had a low risk of metastatic disease, but a high risk of recurrence. Staging CT scans did not reveal evidence of distal spread. The patient is currently receiving 3 years of chemotherapy with imatinib.
authors.affiliation: Department of Gastroenterology, Milton Keynes Hospital, Milton Keynes, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Sadeghi
authors.affiliation: Department of Gastroenterology, Milton Keynes Hospital, Milton Keynes, UK.
authors.forename: Sandro
authors.initials: S
authors.lastname: Lanzon-Miller
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D053704:Capsule Endoscopy; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use*; D007443:Intussusception / Q000150:complications* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D007580:Jejunal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate