SMALL INTESTINE INTUSSUSCEPTION DUE TO GASTROINTESTINAL STROMAL TUMOUR IN PREGNANCY: A CASE REPORT
Journal
Academic Medical Journal
Date Issued
2022
Author(s)
Simonovska Paneva, Iva
Todorovska, Irena
Joksimovic, Marija
Dimitrovski, Sasho
Girevski, Vlatko
Milkovski, Daniel
Pavlovski, Borivoje
DOI
10.53582/amj2221143s
Abstract
Gastrointestinal stromal tumour (GIST) is very rare in pregnancy and only a few cases
have been described in the literature. We present a case of a 38-year-old primigravida, presented
with non-specific symptoms for the first time in the second trimester. Due to the non-specificity
of the symptoms on one hand and the rarity of the tumour on the other, it took a long time for
the final diagnosis to be made.
Accidentally, on a routine obstetric ultrasound examination, a solid tumour formation
was observed, localized under the lower pole of the left kidney. On MRI of the abdomen, in front
of the left kidney there was a tubular structure, in close relation with small intestine, suspected for
intussusception. At 28 weeks of gestation, an exploratory laparotomy was performed with
resection of the involved part of the jejunum and TT anastomosis. Pregnancy was terminated
electively, by caesarean section, in 38+6 gestational weeks.
The clinical presentation of the GIST depends on the primary location of the tumour.
Due to the extremely rare occurrence of these tumours in pregnancy, there is no solid scientific
evidence for the most appropriate time of their treatment and the time of termination of
pregnancy. The biggest challenge in pregnancy is timely diagnosis and treatment, without impact
on the foetus. A multidisciplinary approach is needed. In our case, the severity of the mother’s
symptoms outweighed the danger to the foetus from general anaesthesia and surgery itself.
have been described in the literature. We present a case of a 38-year-old primigravida, presented
with non-specific symptoms for the first time in the second trimester. Due to the non-specificity
of the symptoms on one hand and the rarity of the tumour on the other, it took a long time for
the final diagnosis to be made.
Accidentally, on a routine obstetric ultrasound examination, a solid tumour formation
was observed, localized under the lower pole of the left kidney. On MRI of the abdomen, in front
of the left kidney there was a tubular structure, in close relation with small intestine, suspected for
intussusception. At 28 weeks of gestation, an exploratory laparotomy was performed with
resection of the involved part of the jejunum and TT anastomosis. Pregnancy was terminated
electively, by caesarean section, in 38+6 gestational weeks.
The clinical presentation of the GIST depends on the primary location of the tumour.
Due to the extremely rare occurrence of these tumours in pregnancy, there is no solid scientific
evidence for the most appropriate time of their treatment and the time of termination of
pregnancy. The biggest challenge in pregnancy is timely diagnosis and treatment, without impact
on the foetus. A multidisciplinary approach is needed. In our case, the severity of the mother’s
symptoms outweighed the danger to the foetus from general anaesthesia and surgery itself.
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