Background: Gastrointestinal tumors can grow from epithelial or mesenchymal tissue. Gastrointestinal stromal tumors (GIST) arise from mesenchymal tissue. GISTs start and grow from specialized interstitial nerve cells in the wall of the gastrointestinal tract. At the time of diagnosis the median size of GISTs is 5-7 cm. Small GISTs usually do not have clinical symptoms. The most important symptom of larger GISTs is anemia caused by intraluminal bleeding. These tumors are most common in adults between ages 50 and 70 and make up < 1% of all neoplasma within the digestive tract. Diagnostic procedures for GIST usually include: Endoscopy, Computerized tomography scan (CT), Endoscopic ultrasound (EUS) and Fine-needle aspiration biopsy, and rarely, routine transabdominal sonography (TAUS). Objective: This article presents a case of heavy gastric bleeding GIST that was detected with routine abdominal sonography after negative finding of previous gastroscopy. Case report: A 52-year-old woman presented with a history of intermittent melena during the last 6 months, abdominal pain and anemia. The patient had previously performed gastroscopy and colonoscopy, however the cause of bleeding was not found. On initial clinical investigation there was an evidence of gastrointestinal bleeding (melena and anemia). Physical examination of the abdomen revealed soft painless mass in the left hypochondrium. Laboratory tests confirmed anemia: Hemoglobin 63 (normal range 120-160 g/l), Red blood cell count 2,4 E (normal range 3,9-5,0 x 1012/l). Biochemistry analysis of blood showed no significant abnormalities. Transabdominal sonography showed a well visualized tumor mass measuring 99.9 mm in the left hypochondrium between the stomach and the spleen. CT scan confirmed diagnosis and adequate surgical resection was done..Conclusion: Transabdominal ultrasonography plays an important role in diagnostic workup of cases with gastrointestinal bleeding. It can detect tumor mass and obtain the important information for the next step in diagnostic procedures.
Key words: gastrointestinal bleeding, gastrointestinal stromal tumor (GIST), transabdominal sonography, anemia.
|
