Small Bowel GIST: Clinical Presentation as Intussusception and Obscure Bleeding

http://dx.doi.org/10.1016/j.jpge.2015.12.007 2341-4545/© 2016 Sociedade Portuguesa de Gastrenterologia. Published CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4 umors and only 0.04% of small intestinal malignant neolasms. GISTs may occur anywhere along gastrointestinal ract, but most commonly arise in the stomach (40--60%) nd jejunum/ileum (25--30%).1,2 The clinical presentation of GISTs is highly variable epending on their size, location and presence of mucosal lceration. Abdominal pain and gastrointestinal bleeding when mucosal ulceration is present) are the most common ymptoms or signs although persistent significant bleeding s unusual. Intussusception and subsequent obstruction is very uncommon presentation of these lesions because f their tendency to grow in an extraluminal fashion.3,4 ery few cases of small bowel intussusceptions from stromal umor in adults have been described in medical literature.1--5 ntussusception is rather infrequent in adults, accounting or 0.1% of all surgical admissions and 1--5% of mechanical owel obstructions. In contrast to childhood, where intususception is idiopathic in 90% of cases, in adults a definable athologic lesion is established in over 90% of cases, with eoplasms considered to be the cause in 65% of them. Preoprative diagnosis is often difficult because the symptoms are onspecific.1--3 Intussusception is correctly diagnosed preopratively in only one-third of cases.1,3 The relative rarity of GISTs combined with nonspecific resentation results in delayed diagnosis. Frequently, this is nly possible after surgery and histological examination.2,3,5