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Duodenal giant stromal tumor combined with ectopic varicose hemorrhage: A case report

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are mesenchymal tissue tumors originating from Cajal cells, presenting diverse clinical manifestations due to the different sizes, locations, and growth patterns of the lesions. Duodenum is an uncommon site of GISTs, more with gastrointestinal obst...

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Autores principales: Li, Da-Huan, Liu, Xue-Ying, Xu, Liang-Bi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723731/
https://www.ncbi.nlm.nih.gov/pubmed/33344599
http://dx.doi.org/10.12998/wjcc.v8.i23.6009
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author Li, Da-Huan
Liu, Xue-Ying
Xu, Liang-Bi
author_facet Li, Da-Huan
Liu, Xue-Ying
Xu, Liang-Bi
author_sort Li, Da-Huan
collection PubMed
description BACKGROUND: Gastrointestinal stromal tumors (GISTs) are mesenchymal tissue tumors originating from Cajal cells, presenting diverse clinical manifestations due to the different sizes, locations, and growth patterns of the lesions. Duodenum is an uncommon site of GISTs, more with gastrointestinal obstruction and bleeding as the first symptoms. Ectopic duodenal varix, as a rare varix occurring outside the gastroesophageal region, is the main type of heterotopic varices and an unusual cause of gas-trointestinal hemorrhage. The etiology is mainly seen in liver cirrhosis, portal hypertension, vasculitis, portal vein embolism and obstruction caused by various factors. Reports of duodenal stromal tumor combined with ectopic variceal hemorrhage are rarely seen; however, when it occurs, the situation can sometimes be urgent and life-threatening, especially when traditional endoscopy and imaging fail to detect the lesion timely. CASE SUMMARY: We report a 52-year-old female patient who had no obvious inducement to develop black stool. Gastroscopy in a local hospital revealed that the duodenal horizontal ectopic varices were ruptured and bleeding. After metal clamping hemostasis, she still had gastrointestinal bleeding and was transferred to our hospital. Gastroscopy showed that active bleeding was still seen in the horizontal part of duodenum, and suspicious submucosal eminence was seen in the bleeding part. Abdominal computed tomography showed a huge stromal tumor of duodenum, specimens were pathologically confirmed after surgery. After a 3-mo follow-up, no gastrointestinal hemorrhage and complications occurred. CONCLUSION: Ectopic variceal hemorrhage is rare but sometimes fatal. It may be combined with stromal tumor, which can be diagnosed by multiple methods. Endoscopic and surgical treatment are effective.
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spelling pubmed-77237312020-12-18 Duodenal giant stromal tumor combined with ectopic varicose hemorrhage: A case report Li, Da-Huan Liu, Xue-Ying Xu, Liang-Bi World J Clin Cases Case Report BACKGROUND: Gastrointestinal stromal tumors (GISTs) are mesenchymal tissue tumors originating from Cajal cells, presenting diverse clinical manifestations due to the different sizes, locations, and growth patterns of the lesions. Duodenum is an uncommon site of GISTs, more with gastrointestinal obstruction and bleeding as the first symptoms. Ectopic duodenal varix, as a rare varix occurring outside the gastroesophageal region, is the main type of heterotopic varices and an unusual cause of gas-trointestinal hemorrhage. The etiology is mainly seen in liver cirrhosis, portal hypertension, vasculitis, portal vein embolism and obstruction caused by various factors. Reports of duodenal stromal tumor combined with ectopic variceal hemorrhage are rarely seen; however, when it occurs, the situation can sometimes be urgent and life-threatening, especially when traditional endoscopy and imaging fail to detect the lesion timely. CASE SUMMARY: We report a 52-year-old female patient who had no obvious inducement to develop black stool. Gastroscopy in a local hospital revealed that the duodenal horizontal ectopic varices were ruptured and bleeding. After metal clamping hemostasis, she still had gastrointestinal bleeding and was transferred to our hospital. Gastroscopy showed that active bleeding was still seen in the horizontal part of duodenum, and suspicious submucosal eminence was seen in the bleeding part. Abdominal computed tomography showed a huge stromal tumor of duodenum, specimens were pathologically confirmed after surgery. After a 3-mo follow-up, no gastrointestinal hemorrhage and complications occurred. CONCLUSION: Ectopic variceal hemorrhage is rare but sometimes fatal. It may be combined with stromal tumor, which can be diagnosed by multiple methods. Endoscopic and surgical treatment are effective. Baishideng Publishing Group Inc 2020-12-06 2020-12-06 /pmc/articles/PMC7723731/ /pubmed/33344599 http://dx.doi.org/10.12998/wjcc.v8.i23.6009 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Li, Da-Huan
Liu, Xue-Ying
Xu, Liang-Bi
Duodenal giant stromal tumor combined with ectopic varicose hemorrhage: A case report
title Duodenal giant stromal tumor combined with ectopic varicose hemorrhage: A case report
title_full Duodenal giant stromal tumor combined with ectopic varicose hemorrhage: A case report
title_fullStr Duodenal giant stromal tumor combined with ectopic varicose hemorrhage: A case report
title_full_unstemmed Duodenal giant stromal tumor combined with ectopic varicose hemorrhage: A case report
title_short Duodenal giant stromal tumor combined with ectopic varicose hemorrhage: A case report
title_sort duodenal giant stromal tumor combined with ectopic varicose hemorrhage: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723731/
https://www.ncbi.nlm.nih.gov/pubmed/33344599
http://dx.doi.org/10.12998/wjcc.v8.i23.6009
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