Duodenal Wedge Resection for Large Gastrointestinal Stromal Tumour Presenting with Life-Threatening Haemorrhage

Abstract EN

Background.

Duodenal gastrointestinal stromal tumours (GISTs) are an uncommon malignancy of the gastrointestinal (GI) tract.

We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection.

Case Presentation.

A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding.

After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5 cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy.

A successful limited wedge resection of the tumour mass was performed.

Histopathology subsequently confirmed a duodenal GIST.

The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread.

Conclusion.

Duodenal GISTs can present with life-threatening upper GI haemorrhage.

In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection.

This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.