Nontraumatic Hemoperitoneum Due To Spontaneous Gastrointestinal Stromal Tumor Rupture: a case report

Reprint requests to: Dr. Chung-Yi Wang Department of Emergency Medicine, Mackay Memorial Hospital, Taitung Branch. No. 1, Lane 303, Changsha Street, Taitung, Taiwan, R.O.C. This study describes the case of a previously healthy 51-year-old male patient who complained of sudden abdominal pain. Physical examinations revealed overt peritonitis, and computed tomography showed a hypervascular solid tumor with massive hemoperitoneum. Gastrointestinal stromal tumor (GIST) rupture was highly suspected. Emergent laparotomy with surgical resection of the tumor was performed and the patient was discharged home uneventfully on the 17th postoperative day. The immunohistochemical characteristics of the tumor revealed it to be a gastrointestinal stromal tumor. A gastrointestinal stromal tumor (GIST) is a rare mesenchymal tumor of the small bowel that is exophytic in most cases. The clinical symptoms of GIST range from mild to severe, and complications include vague abdominal pain, hematemesis, and intestinal obstruction. However, overt peritonitis caused by GIST rupture is very uncommon. This paper describes the clinical course of acute abdomen caused by a rare case of ruptured exophytic small bowel GIST.