Two Cases of Gastrointestinal Stromal Tumour Presenting Uncommonly as Intraperitoneal Rupture in Patients Prescribed Warfarin

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RCH Nung, SSM Wong, RKL Lee, ABW Chan, YYP Lee

Hong Kong J Radiol 2016;19:132-6

DOI: 10.12809/hkjr1615376

Gastrointestinal stromal tumour (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Common presentations of GIST include early satiety, indigestion, bloating, vague abdominal pain, and gastrointestinal bleeding. Intraperitoneal rupture is an uncommon presentation of GIST. We have encountered two patients prescribed warfarin, who presented with intraperitoneal haemorrhage as their initial presentation of gastric GIST. Computed tomography (CT) revealed a submucosal gastric mass with intralesional and intraperitoneal haemorrhage. The diagnosis of ruptured GIST was made based on CT findings. These two cases are, to the best of our knowledge, the first two cases with rupture and intraperitoneal haemorrhage as the initial presentation of gastric GIST while on warfarin.