A Rare Case of Acute Abdomen Caused by Perforation of Jejunal Gastrointestinal Stromal Tumor (Gist): A Case Report and Literature Review

Abstract Background: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal system and it accounts for between 1-3% of all gastrointestinal malignancies. GIST arises most commonly from the stomach in 60 – 70% of cases. The clinical presentation of acute abdomen, due to GIST perforation, was a particularly rare described complication of this disease. Our case report aimed to present a case of acute abdomen in an elderly female patient, due to jejunal GIST perforation. Case presentation: A 76-year-old female patient presented with acute abdomen to the emergency surgical unit University Clinical Center of Kragujevac. Computed tomography (CT) scan with intravenous contrast showed pneumoperitoneum, the presence of a 75 x 35 mm irregular fluid collection in the left lower quadrant of the abdomen with air inclusions and signs of small intestine perforations. The patient underwent an emergency laparotomy. Intraoperative findings showed the acute inflammatory reaction of the peritoneum with free bowel contents in the abdominal cavity due to jejunal tumor perforation. Partial resection of the small intestine with tumor was performed followed by intestine anastomosis. Histopathological examination of a specimen revealed a completed resected jejunal gastrointestinal stromal tumor. CONCLUSIONS: GIST arises from the small intestine in 25-30% of cases, and jejunum in 10% of cases. Perforation of GIST and acute diffuse peritoneal inflammation was rare complication of the disease. Emergency laparotomy and complete resection of tumors are essential.