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Abstract

Gastrointestinal Stromal Tumors (GISTs) occur in less than 1% of all digestive tract tumors. Tumor perforation, GIST related fistulas and intra-abdominal abscess phenomenon are rare and occur as a result of GISTs� propensity to cause mucosal ulceration. This allows gut bacteria to enter the systemic circulation which increases the risk for bacteremia. This case report investigated a 53-year-old male whose initial symptoms included fever, chills, leukocytosis, abdominal pain and a palpable right lower quadrant mass. Enhanced computed tomography (CT) scan of the abdomen revealed necrosis and abscess formation at the right lower quadrant. An ileal mass (7x10.7x12.5 cm) that formed a fistula between the tumor & small bowel with mesenteric thickening. Patient underwent exploratory laparotomy, segmental jejunal resection with end-toend anastomosis, excision of mesenteric mass and drains. Imatinib mesilate 400mg orally once a day was initiated as adjuvant treatment. Findings of intestinal fistula and intra-abdominal abscess formation in association with an Ileal GIST should raise a concern both for metastatic disease and possible infectious complication or sequelae. A timely and appropriate initiation of intravenous (IV) antibiotics and resection of the intraabdominal mass is tantamount to increase chances of survival.

Biography

Dr. Ramon Guelos Jr is a 2nd year Medical Resident in Internal Medicine at The Medical City Iloilo, Philippines. He is a graduate of Bachelor of Science in Nursing, Cum Laude last 2015 from West Visayas State University, Iloilo City and his Doctor of Medicine from Central Philippine University, Iloilo City last 2019. He underwent his Post Graduate Intership at Jose R. Reyes Memorial Medical Center, Sta. Cruz, Manila.