Case Report
Recurrent gastric volvulus associated with a gastrointestinal stromal tumor: A case report

https://doi.org/10.1016/j.ijscr.2019.03.031Get rights and content
Under a Creative Commons license
open access

Highlights

  • A 7-cm gastrointestinal stromal tumor (GIST) caused recurrent abdominal pain, apparently through gastric volvulus (GV).

  • The risk of GV based on the size and location of a tumor is unknown.

  • Prompt surgical intervention is indicated in cases of recurrent GV.

Abstract

Introduction

Gastric volvulus (GV) is defined as a rotation of the stomach along its short or long axis leading to variable degrees of gastric outlet obstruction. Rotation of the stomach >180° may cause closed loop obstruction and possible strangulation, which often causes acute abdominal pain. Strangulation and gangrene of the twisted stomach sometimes occurs, which demands immediate surgical intervention. We report a case of acute gastric volvulus due to a gastrointestinal stromal tumor (GIST), with multiple recurrences, that eventually required emergency gastrectomy.

Presentation of the case

A 71-year-old woman with a history of recurrent epigastric pain, nausea, and anorexia was diagnosed to have a 70-mm sized submucosal tumor (SMT) in the lesser curvature of the stomach. An elective gastrectomy was planned; however, before the procedure, she visited the emergency room with acute recurrent epigastric pain associated with postural variations. Computed tomography (CT) revealed a GV and the tumor had shifted to the greater curvature. An emergency gastrectomy was performed. The postoperative course was uneventful and pathological examination revealed features consistent with that of GIST.

Discussion

GV with GIST has rarely been reported and risk factors such as size or localization are unknown. In this case, GV was probably caused by GIST of the stomach, which was large and heavy enough to rotate the gastric body around the mesenteroaxis.

Conclusion

Surgical intervention without delay should be planned in similar scenarios accounting for the risk of GV in GIST.

Abbreviations

GV
gastric volvulus
GIST
gastrointestinal stromal tumor
SMT
submucosal tumor
CT
computed tomography

Keywords

Gastrointestinal stromal tumor
Submucosal tumor
Gastric volvulus
Gastrectomy
Acute abdominal syndrome
Epigastric pain

Cited by (0)