Laparoscopic Small Bowel Resection of Gastrointestinal Stromal Tumour after Angiographic Diagnosis and Successful Embolization


Gastrointestinal stromal tumors (GIST) account for 2% of all tumors of the digestive tract. They are most frequently located in the stomach followed by the small intestine and most often present with mucosal ulceration and erosion associated with gastrointestinal bleeding. Bleeding from the small intestine can be difficult to diagnose and angiography becomes a useful diagnostic and therapeutic procedure in these patients. We present a case of a GIST located in the ileum which presented with a lower gastrointestinal bleeding (LGIB). The patient was stabilized by performing an arteriography and selective embolization of the bleeding point, followed by elective surgery.

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M. Albir, R. Martí, F. Mozos, N. Fernández, J. Rosaleny and J. Serrano, "Laparoscopic Small Bowel Resection of Gastrointestinal Stromal Tumour after Angiographic Diagnosis and Successful Embolization," International Journal of Clinical Medicine, Vol. 2 No. 5, 2011, pp. 640-643. doi: 10.4236/ijcm.2011.25109.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] P. G. Casali, L. Jost, P. Reichardt, M. Schlemmer and J. Y. Blay, “Gastrointestinal Stromal Tumours: ESMO Clinical Recomendations for Diagnosis, Treatment and Follow-up,” Annals of Oncology, Vol. 20, No. 4, 2009, pp. 64-67. doi:10.1093/annonc/mdp131
[2] M. Miettinen, M. Majidi and J. Lasota, “Pathology and Diagnostic Criteria of Gastrointestinal Stromal Tumors (GISTs): A Review,” European Journal of Cancer, Vol. 38, Suppl. 5, 2002, pp. 39-51. doi:10.1016/S0959-8049(02)80602-5
[3] A. Poveda, V. Artigas, A. Casado, J. Cervera , X. García Del Muro, J. Antonio López-Guerrero, A. López-Pousa, J. Maurel, L. Ortega, R. Ramos, I. Romero, M. J. Safont and J. Martín, “Clinical Practice Guidelines in Gastrointestinal Stromal Tumours (GEIS): Update 2008,” Cirugia Espanola, Vol. 84, Suppl. 1, 2008, pp. 1-21.
[4] J. J. Farrell and L. S. Friedman, “Review Article: The Management of Lower Gastrointestinal Bleeding,” Alimentary Pharmacology & Therapeutics, Vol. 21, No. 11, 2005, pp. 1281-1298. doi:10.1111/j.1365-2036.2005.02485.x
[5] G. Demetri, R. Benjamin, C. D. Blanke, J. Y. Blay, P. Casali, H. Choi, C. L. Corless, M. Debiec-Rychter, R. P. DeMatteo, D. S. Ettinger, G. A. Fisher, C. D. Fletcher, A. Gronchi, P. Hohenberger, M. Hughes, H. Joensuu, I. Judson, A. Le Cesne, R. G. Maki, M. Morse, A. S. Pappo, P. W. Pisters, C. P. Raut, P. Reichardt, D. S. Tyler, A. D. Van den Abbeele, M. von Mehren, J. D. Wayne, J. Zalcberg, et al., “NCCN Task Force Report: Optimal Management of Patients with Gastrointestinal Stomal Tumors (GIST)—Update of
[6] M. Miettinen and J. Lasota, “Gastrointestinal Stromal Tumors. Review on Morphology, Molecular Pathology, Prognosis, and Differential Diagnosis,” Archives Pathology & laboratory Medicine, Vol. 130, No. 10, 2003, pp. 1466-1476.
[7] S. Lau, C. K. Tam, C. K. Kam, C. Y. Lui, C. W. Siu, H. S. Lam and K. L. Mak, “Imaging of Gastrointestinal Stromal Tumor (GIST),” Clinical Radiology, Vol. 59, No. 6, 2004, pp. 487-498. doi:10.1016/j.crad.2003.10.018
[8] Jürgen Barnert and Helmut Messmann, “Diagnosis and Management of Lower Gastrointestinal Bleeding,” Nature Reviews Gastroenterology Hepatology, Vol. 6, 2009, pp. 637-646. doi:10.1038/nrgastro.2009.167
[9] N. Kurihara, K. Kikuchi, N. Kurihara, K. Kikuchi, M. Ta- nabe, Y. Kumamoto, A. Tsuyuki, Y. Fujishiro, Y. Otani, T. Kubota, K. Kumai and M. Kitajima, “Parcial Resection of the Second Portion of the Duodenum for Gastrointestinal Stromal Tumor after Effective Transarterial Embolization,” International Journal of Clinical Oncology, Vol. 10, No. 6, 2005, pp. 433-437. doi:10.1007/s10147-005-0503-z
[10] Y. Otani, T. Furukawa, M. Yoshida, Y. Saikawa, N. Wada, M. Ueda, T. Kubota, M. Mukai, K. Kameyama, Y. Sugino, K. Kumai and M. Kitajima, “Operative Indications for Relatively Small (2 - 5cm) Gastrointestinal Stromal Tumors of the Stomach Based on Analysis of 60 Operated Cases,” Surgery, Vol. 139, No. 4, 2006, pp. 484- 492. doi:10.1016/j.surg.2005.08.011
[11] K. L. Huguet, R. M. Rush Jr, D. J. Tessier, R. T. Sch- linkert, R. A. Hinder, G. G. Grinberg, M. L. Kendrick and K. L. Harold, “Laparoscopic Gastric Gastrointestinal Stromal Tumor Resection: The Mayo Clinic Experience,” Achives of Surgery, Vol. 143, No. 6, 2008, pp. 587-590. doi:10.1001/archsurg.143.6.587
[12] F. Catena, M. Di Battista, P. Fusaroli, L. Ansaloni, V. Di Scioscio, D. Santini, M. Pantaleo, G. Biasco, G. Caletti and A. Pinna, “Laparoscopic Treatment of Gastric GIST: Report of 21 Cases and Literature’s Review,” Journal of Gastrointestinal Surgery, Vol. 12, No. 3, 2008, pp. 561- 568. doi:10.1007/s11605-007-0416-4
[13] E. I. Bedar, J. Mamazza, C. M. Schlachta and E. C. Poulin, “Laparoscopic Resection of Gastrointestinal Stromal Tumors: Not All Tumors are Created Equal,” Surgical Endoscopy, Vol. 20, No. 3, 2006, pp. 500-503.
[14] R. Beriduague, E. M. Targarona, X. Feliu, V. Artigas, C. Balagué, A. Aldeano, A. Lahoud, J. Navines, E. Fernandez-Sallent and M. Trias, “Laparoscopic Resection of Clinically Suspected Gastric Stromal Tumors,” Surgical Innovation, Vol. 13, No. 4, 2007, pp. 231-237. doi:10.1177/1553350606295960
[15] Y. W. Novitsty, K. W. Kercher, R. F. Sing and B. T. Heniford, “Long-Term Outcomes of Laparoscopic Resection of Gastric Gastrointestinal Stromal Tumors,” Annals of Surgery, Vol. 243, No. 6, 2006, pp. 738-745. doi:10.1097/01.sla.0000219739.11758.27
[16] M. Iwahashi, K. Takifuji, T. Ojima, M. Nakamura, M. Nakamori, Y. Nakatani, K. Ueda, K. Ishida, T. Naka, K. Ono and H. Yamaue, “Surgical Management of Small Gastrointestinal Stromal Tumors of the Stomac,” World Journal of Surgery, Vol. 30, No. 1, 2006, pp. 28-35. doi:10.1007/s00268-005-7944-4
[17] C. D. Blanke, B. L. Eisenberg and M. C. Heinrich, “Gastrointestinal Stromal Tumors,” Current Treatmant Options in Oncology, Vol. 2, No. 6, 2001, pp. 61-65.
[18] R. P. DeMatteo, J. J. Lewis, D. Leung , S. S. Mudan, J. M. Woodruff and M. F. Brennan, “Two Hundred Gastrointestinal Stromal Tumors: Recurrence Patterns and Prognosis Factors for Survival,” Annals of Surgery, Vol. 231, No. 1, 2000, pp. 51-58. doi:10.1097/00000658-200001000-00008

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