Case report of gastric gastrointestinal stromal tumor complicated by bleeding and a concomitant choledocholithiasis

• Faizulina R.R.
• Nuzova O.B.
• Savin D.V.
• Taranets K.O.

Abstract

Background. Gastrointestinal stromal tumors (GISTs) are the most common sarcomas of the gastrointestinal tract – about 20% of all soft tissue sarcomas. Stomach is the most common localization of GIST (55% of all cases). GISTs don’t have any specific clinical symptoms and may complicate the diagnosis.

Aim was to demonstrate the clinical case of the diagnosis and treatment of the GIST of the stomach complicated by bleeding and a concomitant choledocholithiasis.

Material and results. In the given case report, the experience of managing a patient with the GIST of the stomach and a concomitant choledocholitiasis is introduced. The patient has received treatment for severe anemia at the internal medicine department. In the process of searching for the etiology of anemia, GIST of the gastric antrum was identified. To exclude tumor metastasis to regional lymph nodes and neighboring organs, the patient underwent a contrast enhanced computed tomography of the abdominal cavity as a follow-up examination, as a result of which choledocholithiasis was detected. As the first step of the treatment, the endoscopic retrograde cholangiopancreatography, papillosphincterotomy, lithoextraction for choledocholithiasis has been performed. As the second step of the treatment, the distal gastrectomy with Ya.D. Vitebsky’s anastomosis has been performed. As a result of the subsequent histological examination, a diagnosis was made – a gastrointestinal stromal tumor of the stomach (spindle cell variant) with signs of necrosis, the resection line is free of tumor cells. On the 7th day after the operation, the patient was discharged from the hospital in a satisfactory condition under the supervision of an oncologist.

Conclusion. This clinical case demonstrates the importance of the further research on the gastric GIST in order to develop reliable clinical signs for early diagnosis and subsequent minimally invasive treatment.

Keywords:gastrointestinal stromal tumors; stomach; case report; gastrectomy; endoscopic retrograde cholangiopancreatography

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