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Case Reports in Gastrointestinal Medicine
Volume 2013 (2013), Article ID 562642, 5 pages
http://dx.doi.org/10.1155/2013/562642
Case Report

Duodenal Wedge Resection for Large Gastrointestinal Stromal Tumour Presenting with Life-Threatening Haemorrhage

1Department of Plastic Surgery, Wexham Park Hospitals, Slough SL2 4HL, UK
2Department of General Surgery, Oxford University Hospitals NHS Trust, Horton General Hospital, Banbury OX16 9AL, UK
3Department of Urology, Wexham Park Hospitals, Slough SL2 4HL, UK
4Department of Radiology, Oxford University Hospitals NHS Trust, Horton General Hospital, Banbury OX16 9AL, UK

Received 21 January 2013; Accepted 26 February 2013

Academic Editors: I. D. Kyriazanos, R. J. L. F. Loffeld, and S. Tanaka

Copyright © 2013 Alexander Shaw et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Duodenal gastrointestinal stromal tumours (GISTs) are an uncommon malignancy of the gastrointestinal (GI) tract. We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding. After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5 cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy. A successful limited wedge resection of the tumour mass was performed. Histopathology subsequently confirmed a duodenal GIST. The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread. Conclusion. Duodenal GISTs can present with life-threatening upper GI haemorrhage. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.