Intest Res.
2013 Apr;11(2):113-119. 10.5217/ir.2013.11.2.113.
A Clinical Analysis of Gastrointestinal Stromal Tumors in Small Intestine: Comparison of Bleeding and Non-bleeding Group
- Affiliations
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- 1Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea. saiah@naver.com
- 2Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Korea.
- KMID: 2174280
- DOI: http://doi.org/10.5217/ir.2013.11.2.113
Abstract
- BACKGROUND/AIMS
Gastrointestinal stromal tumors (GIST) in the small intestine are rare and can cause bleeding. The study investigated the clinical characteristics of GIST in the small intestine and to determine the factors related to gastrointestinal bleeding.
METHODS
We retrospectively evaluated the clinical outcomes of 22 patients with small bowel GIST who were pathologically diagnosed at Gangneung Asan Hospital between March 1997 and August 2012.
RESULTS
The median age was 63.5 (38-82) years. Nine patients (40.9%) had gastrointestinal bleeding, five patients (22.7%) had abdominal pain, two patients (9%) had palpable mass. The site of tumor was the duodenum in nine cases (40.9%), jejunum in 7 cases (31.8%), and ileum in six cases (27.3%). Most patients underwent small bowel resection or wedge resection but three patients underwent pancreaticoduodenectomy. Tumor size ranged from 1.6 to 19 cm (median 6.5 cm). The median mitotic rate was 2 (0-50)/50 high power fields (HPF). The median mitotic rate was 2 (0-50)/50 HPF. Five patients (25%) showed recurrence. Gender, aspirin or warfarin use, size and mitotic index of tumor, hospital stay, recurrence and survival were not significantly different between bleeding and non-bleeding group. Bleeding group showed older age, proximal location in small intestine and mucosal ulceration significantly.
CONCLUSIONS
Small bowel GISTs with bleeding were marked by older age, mucosal ulceration and location of proximal small bowel (duodenum and jejunum) rather than distal small bowel (ileum).
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