Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum

Gastrointestinal stromal tumors are rare tumors and correspond to 1% of all gastrointestinal neoplasms; duodenal location only represents between 3-5%. This case report was made for disclosing the surgical strategy followed in a patient with invasive gastrointestinal stromal tumors (>10 cm) o...

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Main Author: Tomás Ariel Lombardo Vaillant
Format: Article
Language:Spanish
Published: Centro Provincial de Información de Ciencias Médicas. Cienfuegos 2023-03-01
Series:Medisur
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Online Access:http://medisur.sld.cu/index.php/medisur/article/view/5536
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author Tomás Ariel Lombardo Vaillant
author_facet Tomás Ariel Lombardo Vaillant
author_sort Tomás Ariel Lombardo Vaillant
collection DOAJ
description Gastrointestinal stromal tumors are rare tumors and correspond to 1% of all gastrointestinal neoplasms; duodenal location only represents between 3-5%. This case report was made for disclosing the surgical strategy followed in a patient with invasive gastrointestinal stromal tumors (>10 cm) of atypical location in the duodenum fourth portion. Hospitalization was due to abdominal tumor and anemia. The clinical exercise consisted of identifying a left abdominal mass with lumbar contact. The diagnostic tests performed were: blood chemistry tests, abdominal ultrasound, computerized axial tomography, and digestive endoscopy with biopsy that confirmed the diagnosis. The surgical procedure was resection of the duodenum fourth portion and the first jejunal loops, with restoration of intestinal function through duodenum (second portion) lateral jejunostomy. The surgery was interrupted due to the patient's hemodynamic instability, and four days later he was taken back to the operating room due to peritonitis, with pus coming out of the abdominal drains, which was resolved by washing the cavity. Morbidity was accompanied by a pancreatic fistula. In the third surgical time, resection of the residual tumor, left nephrectomy, and control of the pancreatic fistula were performed. After one year the patient is free of tumor disease. The management strategy in patients with atypically located gastrointestinal stromal tumors represents a challenge for the surgeon as a member of the multidisciplinary group and depends on the extent of the tumor, the patient's condition, and the surgical team timely management.
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language Spanish
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publisher Centro Provincial de Información de Ciencias Médicas. Cienfuegos
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spelling doaj-art-ef1bab1bc5a940979e8c7763980d7af82025-01-30T21:29:00ZspaCentro Provincial de Información de Ciencias Médicas. CienfuegosMedisur1727-897X2023-03-012124714812271Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenumTomás Ariel Lombardo Vaillant0Hospital Militar Principal de Luanda. República de Angola.Gastrointestinal stromal tumors are rare tumors and correspond to 1% of all gastrointestinal neoplasms; duodenal location only represents between 3-5%. This case report was made for disclosing the surgical strategy followed in a patient with invasive gastrointestinal stromal tumors (>10 cm) of atypical location in the duodenum fourth portion. Hospitalization was due to abdominal tumor and anemia. The clinical exercise consisted of identifying a left abdominal mass with lumbar contact. The diagnostic tests performed were: blood chemistry tests, abdominal ultrasound, computerized axial tomography, and digestive endoscopy with biopsy that confirmed the diagnosis. The surgical procedure was resection of the duodenum fourth portion and the first jejunal loops, with restoration of intestinal function through duodenum (second portion) lateral jejunostomy. The surgery was interrupted due to the patient's hemodynamic instability, and four days later he was taken back to the operating room due to peritonitis, with pus coming out of the abdominal drains, which was resolved by washing the cavity. Morbidity was accompanied by a pancreatic fistula. In the third surgical time, resection of the residual tumor, left nephrectomy, and control of the pancreatic fistula were performed. After one year the patient is free of tumor disease. The management strategy in patients with atypically located gastrointestinal stromal tumors represents a challenge for the surgeon as a member of the multidisciplinary group and depends on the extent of the tumor, the patient's condition, and the surgical team timely management.http://medisur.sld.cu/index.php/medisur/article/view/5536tumores del estroma gastrointestinalcirugía general
spellingShingle Tomás Ariel Lombardo Vaillant
Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum
Medisur
tumores del estroma gastrointestinal
cirugía general
title Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum
title_full Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum
title_fullStr Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum
title_full_unstemmed Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum
title_short Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum
title_sort surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum
topic tumores del estroma gastrointestinal
cirugía general
url http://medisur.sld.cu/index.php/medisur/article/view/5536
work_keys_str_mv AT tomasariellombardovaillant surgicalstrategyinapatientwithanaggressivetumorofthegastrointestinaltractinthefourthportionoftheduodenum