Belabbes Fatima Zahra, Ibork Safa, Oqbani Kenza, Bensaad Ahmed
Gastroenterology and Hepatology, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS) Cheikh Khalifa International University Hospital, Casablanca, MAR.
Gastroenterology and Hepatology, Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS) Cheikh Khalifa International University Hospital, Casablanca, MAR.
Cureus. 2023 Apr 8;15(4):e37315. doi: 10.7759/cureus.37315. eCollection 2023 Apr.
Gastrointestinal stromal tumors (GISTs) are rare neoplasms that originate in the gastrointestinal tract. Due to the nonspecific symptoms, they are often underdiagnosed. Patients typically present with abdominal pain, weight loss, asthenia, or a sensation of a "ball in the stomach." Hypovolemic shock is a rare mode of presentation. The biopsy is often inconclusive, and immunohistochemistry plays a crucial role in diagnosis. Surgery is the treatment of choice for stromal tumors with hemorrhage. Here, we present two cases of patients admitted in critical condition with hypovolemic shock. Laboratory results revealed profound anemia. Upper gastrointestinal exploration demonstrated a tumor in both cases, with normal biopsy findings in one case. However, after partial gastrectomy, pathology results revealed GIST with an immunohistochemistry profile in favor. The mode of presentation in our cases is notable, as hypovolemic shock without apparent external bleeding is an unusual presentation. Therefore, physicians should consider GIST a possible diagnosis when presented with a patient in hypovolemic shock, even without externalized bleeding.
胃肠道间质瘤(GISTs)是起源于胃肠道的罕见肿瘤。由于症状不具特异性,它们常常被漏诊。患者通常表现为腹痛、体重减轻、乏力或有“胃中有肿物”的感觉。低血容量性休克是一种罕见的表现形式。活检结果往往不明确,免疫组织化学在诊断中起着关键作用。手术是治疗伴有出血的间质瘤的首选方法。在此,我们报告两例因低血容量性休克而病情危急入院的患者。实验室检查结果显示严重贫血。上消化道探查在两例中均发现有肿瘤,其中一例活检结果正常。然而,部分胃切除术后,病理结果显示为GIST,免疫组织化学结果支持该诊断。我们病例的表现形式值得注意,因为无明显外部出血的低血容量性休克是一种不寻常的表现。因此,即使没有外部出血,当遇到低血容量性休克患者时,医生也应考虑GIST这一可能的诊断。