Rupture of gastrointestinal stromal tumor presenting with sudden onset chest and back pain and accompanied by gastric dilatation
Rupture of gastrointestinal stromal tumor presenting with sudden onset chest and back pain and accompanied by gastric dilatation
复制标题
DOI：
10.1002/ams2.190
复制
发表时间：
2016-10-01
影响因子：
1.6
通讯作者：
Miyagawa, Shinichi
中科院分区：
文献类型：
--
作者：
Nitta, Kenichi;Imamura, Hiroshi;Miyagawa, Shinichi
病例：一位72岁男性高血压患者因急性胸背痛伴上腹痛入院。他因疑似急性主动脉夹层而被直升机运送。两组的收缩压相等。体格检查显示上腹部压痛，无反跳。血液检查显示白细胞增多。心电图和超声心动图正常。腹部放射线检查显示急性胃扩张伴空气轮廓的大肿块样阴影。腹部电脑断层显示一个6厘米的外生肿块和胃体小弯的巨大壁内血肿。结果：病人接受了紧急剖腹手术和全胃切除术。切除的肿瘤显示CD117和CD34阳性，但S100阴性，表明胃肠道间质瘤。手术后14天，患者顺利出院。结论：急性胃扩张的情况下，应考虑粘膜下肿瘤，包括胃肠道间质瘤的壁内出血。腹部X线摄影可能是关于这种情况存在的线索。
Case: A 72-year-old man with hypertension was admitted with acute-onset chest and back pain followed by epigastralgia. He was transported by helicopter due to suspected acute aortic dissection. Systolic blood pressures were equal in both arms. Physical examination showed epigastric tenderness without rebound. Blood tests showed leukocytosis. Electrocardiogram and echocardiogram were normal. Abdominal radiography showed acute gastric dilatation with an air-outlined large mass-like shadow. Abdominal computed tomography revealed a 6-cm exophytic mass and large intramural hematoma in the lesser curvature of the gastric body.Outcome: The patient underwent urgent laparotomy with total gastrectomy. The resected tumor showed positivity for CD117 and CD34 but negativity for S100, indicating a gastrointestinal stromal tumor. Fourteen days after the surgery, the patient was uneventfully discharged.Conclusion: Intramural bleeding of submucosal tumors including gastrointestinal stromal tumor should be considered in cases of acute gastric dilatation. Abdominal radiography may be a clue regarding the presence of this condition.