Recurrent gastric volvulus associated with a gastrointestinal stromal tumor: A case report. (2019)

• Record Type: Journal Article
• Authors: Murata, Ryohei; Kamiizumi, Yo; Ishizuka, Chihiro; Kashiwakura, Sayuri; Tsuji, Takeshi; Kasai, Hironori; Tani, Yasuhiro; Haneda, Tsutomu; Yoshida, Tadashi; Okamoto, Kenzo; Ito, Koji
• Is Part Of: International journal of surgery case reports. Volume 57(2019)
• Page Start: 126
• Page End: 129
• Publication Date: 2019
• Subjects: GV gastric volvulus -- GIST gastrointestinal stromal tumor -- SMT submucosal tumor -- CT computed tomography; Gastrointestinal stromal tumor -- Submucosal tumor -- Gastric volvulus -- Gastrectomy -- Acute abdominal syndrome -- Epigastric pain; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2019.03.031
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: A 7-cm gastrointestinal stromal tumor (GIST) caused recurrent abdominal pain, apparently through gastric volvulus (GV). The risk of GV based on the size and location of a tumor is unknown. Prompt surgical intervention is indicated in cases of recurrent GV. Abstract: Introduction: Gastric volvulus (GV) is defined as a rotation of the stomach along its short or long axis leading to variable degrees of gastric outlet obstruction. Rotation of the stomach >180° may cause closed loop obstruction and possible strangulation, which often causes acute abdominal pain. Strangulation and gangrene of the twisted stomach sometimes occurs, which demands immediate surgical intervention. We report a case of acute gastric volvulus due to a gastrointestinal stromal tumor (GIST), with multiple recurrences, that eventually required emergency gastrectomy. Presentation of the case: A 71-year-old woman with a history of recurrent epigastric pain, nausea, and anorexia was diagnosed to have a 70-mm sized submucosal tumor (SMT) in the lesser curvature of the stomach. An elective gastrectomy was planned; however, before the procedure, she visited the emergency room with acute recurrent epigastric pain associated with postural variations. Computed tomography (CT) revealed a GV and the tumor had shifted to the greater curvature. An emergency gastrectomy was performed. The postoperative course was uneventful and pathological examination revealed features consistent with that of GIST. Discussion: GV with GIST has rarely been reported and risk factors such as size or localization are unknown. In this case, GV was probably caused by GIST of the stomach, which was large and heavy enough to rotate the gastric body around the mesenteroaxis. Conclusion: Surgical intervention without delay should be planned in similar scenarios accounting for the risk of GV in GIST.