Duodenal gastrointestinal stromal tumors (dGISTs) may be a source of life-threatening hemorrhage that leads to emergency surgical care, precluding tumor staging and the planning of an elective treatment. In this study, we report a case of potentially lethal bleeding dGIST in a young woman successfully treated by an organ-preserving elective surgery after endoscopic and angiographic hemostasis. A 26-year-old female patient was admitted to the Emergency Unit of our hospital with the complaints of hematemesis and melena in the previous 12 h. An upper endoscopy showed a 4-cm submucosal lesion, between the 2nd and 3rd part of the duodenum, in the lateral wall, with massive bleeding arising from central ulceration. Hemostasis was initially achieved endoscopically and then optimized by transarterial embolization. After a contrast-enhanced CT, the patient underwent planning elective surgery. Intraoperatively, a 3-cm lesion was confirmed and resected by excision of the full-thickness duodenum with adequate free margins. Immunohistochemical analysis of the specimen revealed to be a dGIST, with a low mitotic count (#x3c;5 mitosis/50 high power field), and tumor necrosis present in #x3c;50% of the lesion. The patient had an uneventful course.
Case Rep Gastroenterol 2021;15:519–524

中文翻译：

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十二指肠胃肠道间质瘤：年轻成年女性患者的一种罕见疾病，出现危及生命的出血

十二指肠胃肠道间质瘤 (dGISTs) 可能是危及生命的出血的来源，导致急诊手术治疗，排除肿瘤分期和择期治疗的计划。在这项研究中，我们报告了一例年轻女性的潜在致命性 dGIST 出血病例，该患者在内窥镜和血管造影止血后通过保留器官的择期手术成功治疗。一名 26 岁女性患者，因 12 小时内出现呕血和黑便，入我院急诊科。上消化道内镜检查显示十二指肠第 2 和第 3 部分之间的外侧壁有 4 厘米的粘膜下病变，中央溃疡引起大量出血。止血最初是通过内窥镜实现的，然后通过动脉栓塞进行优化。对比增强 CT 后，患者接受了计划性择期手术。术中，通过切除全层十二指肠并留有足够的游离边缘，确认并切除了一个 3 厘米的病变。标本的免疫组织化学分析显示为 dGIST，有丝分裂计数低（#x3c；5 有丝分裂/50 高倍视野），#x3c 中存在肿瘤坏死；50% 的病变。病人的病程平安无事。
Case Rep Gastroenterol 2021；15:519–524