Jejunal GIST: An Uncommon Presentation of Obscure GI Bleeding

Abstract

Introduction: Only 0.1-3 percent of all GI malignancies are gastrointestinal stromal tumors, which are the most frequent mesenchymal tumors of the digestive system. Gastrointestinal bleeding, either acute or chronic, is the most typical GIST manifestation. Case Presentation: We describe the case of a 32-year-old man who experienced repeated bouts of melena and hematochezia over the course of four months, necessitating multiple blood transfusions and causing a weight loss of 5 kg. Fresh and clotted blood was seen during a colonoscopy using a 50 cm ileoscopy; however there were no obvious lesions. A wide-based submucosal edema with surface ulceration was discovered by deep enteroscopy via the oral route at 150 cm from the incisor teeth. After the patient had a laparoscopic excision, the diagnosis of a GIST coming from the jejunum was confirmed by histological and immunohistochemistry tests. Conclusion: The diagnosis of bleeding GISTs in the proximal small intestine is challenging due to the inaccessibility of these areas with conventional endoscopes. In such cases, capsule endoscopy or deep enteroscopy plays a valuable role in diagnosis. The primary treatment strategy for jejunal GIST is complete surgical resection.