# A Rare Case of Massive Gastrointestinal Hemorrhage Caused by an Ileal Gastrointestinal Stromal Tumor

## TL;DR

A 71-year-old woman experienced life-threatening intestinal bleeding caused by a rare ileal tumor, requiring surgery after initial treatments failed.

## Contribution

This paper presents a rare clinical case of an ileal GIST causing massive hemorrhage and highlights the role of CTA in diagnosis and management.

## Key findings

- CTA identified active bleeding in the ileal region despite embolization.
- A 4.7cm low-grade GIST was confirmed as the cause after surgical excision.
- The case emphasizes the diagnostic challenges of ileal GISTs.

## Abstract

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal tract. Although gastrointestinal bleeding is a common complication of GISTs, life-threatening hemorrhage is rare, particularly with intestinal GISTs. We report a rare case of an ileal GIST in a 71-year-old female patient who presented with massive lower gastrointestinal bleeding. Initial CT angiography (CTA) demonstrated a brisk gastrointestinal bleed in the ileal region. Despite embolization of the associated distal ileal artery branches, the patient experienced persistent hemoglobin drops and hematochezia. Repeat CTA revealed a hyper-enhancing exophytic lesion in the proximal ileum. This 4.7cm ileal tumor had to be excised, and histopathology confirmed a low-grade GIST. This case highlights the diagnostic complexity of ileal GISTs and the importance of imaging modalities such as CTA in managing active gastrointestinal bleeding.