Spontaneous Terminal Ileum GIST Perforation Causing an Acute Abdomen in an Elderly Patient—A Rare Case

TL;DR

An elderly man experienced an acute abdomen due to a rare perforated tumor in his terminal ileum, highlighting the need to consider such tumors in unusual cases.

Contribution

This case emphasizes the importance of diagnosing GIST perforation in elderly patients and rare anatomical locations.

Findings

An 86-year-old male presented with an acute abdomen caused by a perforated terminal ileum GIST.

The tumor was confirmed as a GIST with a GILT immunophenotype via immunohistochemical examination.

The case underscores the rarity and diagnostic challenges of GISTs in elderly patients and unusual locations.

Abstract

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors primarily located in the stomach and small intestine; their occurrence in the terminal ileum is particularly rare. Although GISTs can develop throughout the gastrointestinal tract, cases of perforation in elderly individuals are even less common, posing significant diagnostic and therapeutic challenges. This case report describes an 86-year-old male patient with an acute abdomen caused by a terminal ileum perforated GIST requiring urgent surgical intervention. An immunohistochemical examination of the tumor confirmed a GIST with a GILT (gastrointestinal leiomyogenic tumor) immunophenotype. The rarity of this condition makes it diagnostically challenging, as its symptoms are often nonspecific, and GISTs are frequently overlooked, particularly in older patients. This case supplements the existing literature by emphasizing the importance of considering GIST perforation in the differential diagnosis of an acute abdomen, even in elderly patients and in rare anatomical locations.

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