A gastrointestinal Stromal Tumor of the Small Bowel Presenting as an Acute Peritonitis: A Case Report

Abstract

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract, GISTs of the small bowel presenting as an acute peritonitis are rare, which necessitates emergency surgery. Presentation of Case: A 44-year-old women presented with severe abdominal pain and nausea. Physical examination revealed a tenderness and muscular defense around the lower abdomen. Laboratory data showed an elevated white blood cell count and C-reactive protein level. An enhanced computed tomography (CT) scan showed a 8 × 10 cm cystic mass in the lower abdomen, which contained air. Emergency laparotomy showed a giant perforated tumor that arose from the ileum, the tumor and affected segment of ileum were resected. the tumor was diagnosed as GIST in low-risk category, and imatinib mesylate was initiated, The patiente had an uneventful postoperative course and remains well. Discussion and Conclusion: Such rare cases can be diagnosed and treated properly with careful clinical evaluation, Computed tomography (CT) is the gold standard for imaging that is used to characterize any abdominal mass. Surgical resection is still the first-line treatment for patients with primary localized and resectable small bowel GIST and adjuvant chemotherapy with imatinib mesylate is indicated in patients with high-risk small bowel GIST.