# Gastrointestinal stromal tumor of the duodenum presenting with shock and massive upper and lower gastrointestinal bleeding: a case report and review of the literature

## TL;DR

A rare case of a duodenal gastrointestinal stromal tumor (GIST) caused life-threatening bleeding and was successfully diagnosed and treated.

## Contribution

This case report highlights the emergency presentation and management of a rare duodenal GIST causing massive upper and lower gastrointestinal bleeding.

## Key findings

- A 61-year-old man presented with shock and severe bleeding from a duodenal GIST.
- The tumor was diagnosed via endoscopy and confirmed as high-risk GIST through immunohistochemistry.
- The patient was treated with surgery and imatinib, remaining recurrence-free.

## Abstract

Due to rarity of duodenal GISTs, clinicians have few information about its clinical features, diagnosis, management and prognosis.

We report a case of promptly diagnosed duodenal GIST in a 61-year-old Egyptian man presented shocked with severe attack of hematemesis and melena. Upper gastroduodenal endoscopy was done and revealed a large ulcerating bleeding mass at first part of duodenum 4 hemo-clips were applied with good hemostasis.

An exploratory laparotomy and distal gastrectomy, duodenectomy and gastrojejunostomy were performed. The morphology of the mass combined with immunohistochemistry was consistent with duodenal gastrointestinal stromal tumours (GISTs) of high risk type. The patient is on amatinib one tablet daily and he was well with no evidence of tumor recurrence.

despite being rare, emergency presentation with sudden severe, life-threatening hemorrhagic shock duodenal GISTs might be a cause of potentially lethal massive combined upper and lower gastrointestinal bleeding which is the key feature of this rare and challenging tumor.