Massive bleeding of a jejunal gastrointestinal stromal tumour

Massive bleeding of a jejunal gastrointestinal stromal tumour: a rare case of a life-threatening presentation:

Abstract

A jejunal gastrointestinal stromal tumour (GIST) is a rare neoplasm of the gastrointestinal tract. Massive bleeding due to a jejunal GIST is a diagnostic challenge and could present as a life-threatening situation needing urgent intervention. A 54-year-old woman presented with episodes of melaena and haematochezia for the previous 3 days. An oesophagoduodenoscopy was inconclusive. A contrast computed tomography (CT) scan showed a well-defined extraluminal mass in the proximal jejunum suggestive of a bleeding GIST. Her haemodynamic state deteriorated despite initial supportive therapy including a blood transfusion. An urgent laparotomy to excise the jejunal mass was performed. Histopathology and immunohistochemical studies confirmed the diagnosis. She subsequently received adjuvant imatinib therapy. She has remained symptom free at 5 months post-op. We therefore present a rare case of obscure massive gastrointestinal bleeding due to a jejunal GIST. The CT scan was the most effective investigation to detect the source of bleeding in this case.