Abstract
The 48 year old patient, admitted to the Clinic IV for Digestive Surgery – Emergency University Hospital, presenting with symptoms of acute abdomen: intense diffuse abdominal pain, paleness of tissue and mucous membranes, nausea and vomiting. Pain started abruptly and agressively in the epigastrium 12 hours before admission to the hospital and then it spread to the abdomen, analgezic, not responding to the usual analgesic treatment. The anamnesis showed the patient repeatedly accused pain in the superior abdominal compartment, associated with nausea and vomiting, interpreted as dyspeptic syndrome of (probably) biliary etiology, responsive to the antispastic treatment. Intraoperatively, a diagnostic was established: hemoperitoneum due to the spontaneous rupture of a voluminous tumor (>10 cm), with extraluminal evolution in the gastric fornix and the macroscopic outlook of a GIST. Total gastrectomy is performed, with DII lymph node dissection (lymphadenectomy) and reconstruction of digestive continuity through Roux-en-Y eso-jejunal-anastomosis. The anatomo-pathological exam highlighted a gastrointestinal stromal tumor (GIST), TNM staging: pT4; pN0 (0/17); LV0; Pn0; R0. The patient had a favourable evolution. Since this type of pathology is extremely rare and difficult to diagnose, we believed it would be useful to present and review its micro and macroscopic aspects.
Highlights
PRACTICA MEDICALÅIntraoperator, s-a stabilit diagnosticul de hemoperitoneu prin ruptură spontană de tumoră voluminoasă (>10 cm) cu dezvoltare extraluminală la nivelul fornixului gastric, cu aspect macroscopic de GIST.
Se practică gastrectomie totală cu limfadenectomie DII și refacerea continuității digestive prin eso-jejuno-anastomoză pe ansă în „y“ à la Roux.
The 48 year old patient, admitted to the Clinic IV for Digestive Surgery – Emergency University Hospital, presenting with symptoms of acute abdomen: intense diffuse abdominal pain, paleness of tissue and mucous membranes, nausea and vomiting.
Summary
Intraoperator, s-a stabilit diagnosticul de hemoperitoneu prin ruptură spontană de tumoră voluminoasă (>10 cm) cu dezvoltare extraluminală la nivelul fornixului gastric, cu aspect macroscopic de GIST. Se practică gastrectomie totală cu limfadenectomie DII și refacerea continuității digestive prin eso-jejuno-anastomoză pe ansă în „y“ à la Roux. The 48 year old patient, admitted to the Clinic IV for Digestive Surgery – Emergency University Hospital, presenting with symptoms of acute abdomen: intense diffuse abdominal pain, paleness of tissue and mucous membranes, nausea and vomiting. Since this type of pathology is extremely rare and difficult to diagnose, we believed it would be useful to present and review its micro and macroscopic aspects. Tratamentul chirurgical de urgență a fost impus de prezența hemoperitoneului spontan diagnosticat ecografic și tomografic, practicându-se gastrectomie totală DII cu eso-jejuno-anastomoză pe ansa în „y“ à la Roux. Acestea asociază un risc înalt de progresie a bolii și de recidivă, precum și o rată scăzută de supraviețuire liberă de boală (DFS), impunând prelungirea tratamentului cu inhibitori de tirozin-kinază peste [3,4,5] ani, împreună cu un follow-up agresiv
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
