Gastrointestinal Stromal Tumor (GIST) Presenting as Acute Abdomen: Images in surgery

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Abstract Gastrointestinal stromal tumors originating from the small bowel are uncommon. we presente the case of a 45-year-old man with no prior medical or surgical history presented to our hospital's emergency department with abdominal pain, vomiting, inability to pass gas, and no bowel movements. Physical examination revealed abdominal distention and tenderness. His white blood cell count was 10.9x10^3/µl, and hemoglobin levels were 13.3 g/dl. A thoraco-abdomino-pelvic CT scan showed air-fluid levels in the ileo-jejunal loops, a soft tissue density mass measuring approximately 77x35 mm, and liver metastasis (Fig. A, B). The patient underwent surgery due to acute abdomen from mechanical ileus. Proximal small bowel dilatation and a 9x4 cm soft-tissue mass protruding from the serosa (Fig. C) were found without luminal obstruction, approximately 70 cm proximal to the ileocecal valve. Additionally, a flange (Fig. D) between the tumor and sigmoid caused ileum loop obstruction. Tumor resection with a linear surgical stapler was performed, and pathology confirmed a gastrointestinal stromal tumor. The patient was discharged on the fourth postoperative day without complications, and an Imatinib treatment plan was initiated.

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