Case Reports in Surgery

Case Report

Adult Intussusception due to Gastrointestinal Stromal Tumor: A Rare Case Report, Comprehensive Literature Review, and Diagnostic Challenges in Low-Resource Countries

Table 1

General characteristics of 18 cases of intussusception due to gastrointestinal stromal tumor reported between 1983 and 2018.
ReferenceCountryAge (year)GenderPresentationDuration of complaintsPalpable massImaging toolSurgical approachTumor locationTumor size largest dimension (cm)Expression for c-Kit/CD117, mitotic indexFollow-up/recurrence
[32]Greece79FLower right abdominal colicky pain, abdominal distention, N + V5 daysNoPlain X-ray, contrast CTLaparotomy, end-to-end ileoileal anastomosisIleum2.2Positive, 7-8 mitoses/50 HPF11 months, no recurrence
[33]Brunei62FEpigastric pain, melena3 daysNoEndoscopy, CTBillroth II, partial gastrectomyDistal body of the stomach5.2Positive, 6 mitoses/50 HPFTaking imatinib mesylate, no recurrence
[34]China34FEpigastric pain, vomiting1 monthNoCT, endoscopyLaparoscopic, wedge resectionFundus6.5Positive, 2 mitoses/50 HPFNo recurrence, on follow-up
[35]USA52FEpigastric pain, vomiting1 dayNoCT, endoscopyLaparoscopic, wedge resectionFundus5.0Positive, 4 mitoses/50 HPF5 months, no recurrence, taking imatinib mesylate
[36]Japan95FVomiting and loss of appetite, melena1 weekNRCT, endoscopyEndoscopic submucosal dissectionPosterior wall of distal body4.2Positive, 4 mitoses/50 HPFNo recurrence, patient died of old age 55 months later
[37]Japan51MN + V, melena, and severe anemia4 daysNoCT, endoscopy Antrum5.5Positive/NRNo recurrence
[38]India65FUpper abdominal pain, intermittent vomiting 30 minutes after meals6 monthsYesCT, endoscopyLaparotomy, wedge resectionPylorus6.0Positive, 0-1 mitosis/50 HPF1 year, no recurrence
[39]Ireland78FUpper abdominal discomfort, vomiting, and anorexia1 weekNRCTEndoscopic reduction, laparoscopic, wedge resectionBody and antrum4.5Positive, NRNo recurrence on follow-up
[40]Ghana59FIntermittent vomiting1 weekYesUSLaparotomy, wedge resectionAnterior wall stomachNRPositive, <1 mitosis/50 HPF12 months, no recurrence
[41]India60FIntermittent vomiting 30 minutes after meals, loss of appetite and weightNRNRCT, endoscopyLaparoscopic, Billroth II, partial gastrectomyAntrum8.0Positive, 2 mitoses/50 HPF14 months, no recurrence
[42]China69FAcute abdominal pain, N + V6 hoursNoEndoscopyLaparoscopic wedge resectionAntrum4.5Negative, but DOG-1 and CD34-positive, no PDGFRA mutation, < 5 mitoses/50 HPF33 months, no recurrence
[43]UK68MAbdominal pain and distension, vomiting, constipation, melenaNRNRCTLaparotomyJejunum4.0Positive, 0-1 mitosis/50 HPFNR, no recurrence
[44]UK70MAbdominal pain, nausea, bilious vomiting, constipation1 weekNRAbdominal X-ray, CTLaparotomy, primary anastomosisJejunum4.0Positive/NR3 months, no recurrence, taking imatinib mesylate
[45]Morocco59FAbdominal distension, pain, constipation, vomiting6 monthsNoCTLaparotomy, primary ileoileal anastomosisIleumNRPositive/NRNR
[46]India46FAbdominal pain, abdominal distension, anorexia, vomiting, constipation36 hoursYesEndoscopy, US, CTLaparotomy, primary jejunojejunal anastomosisJejunum4.0Positive, 6 mitoses/50 HPF2 years, no recurrence, taking imatinib mesylate
[47]India38MAbdominal pain2 monthsYesUS, CT enteroclysisLaparotomy, tumor resectionJejunum15.0Positive, 6 mitoses/50 HPFSix months, no recurrence, taking imatinib mesylate
[48]India59MAbdominal pain, distension, bilious vomiting, constipation3 daysNoPlain X-ray abdomen, USLaparotomy, primary ileoileal anastomosisIleumNRPositive/NRNR
[49]UK36FCollapse, melena, hypotension (82/46 mmHg), tachycardia (150 bpm)NRNoCTLaparotomy, pancreaticoduodenectomyDuodenum15.0Positive/NRNo recurrence
F: female; M: male; NR: not reported; US: ultrasonography; CT: computed tomography; N + V: nausea and vomiting; HPF: high-power field; USA: United States of America; UK: United Kingdom; bpm: beats per minute; DOG-1: discovered on GIST-1; PDGFRA: platelet-derived growth factor receptor alpha.