Quest Journals Journal of Medical and Dental Science Research Volume 8~ Issue 8 (2021) pp: 15-20 ISSN(Online) : 2394-076X ISSN (Print):2394-0751 www.questjournals.org *Corresponding Author: Dr.ParthasarathiHota 15 | Page Research Paper Jejunal GIST presenting as perforativeperitonitis – a case report and review of literature Dr.ParthasarathiHota Assistant Professor, Department of General Surgery,Pacific Institute of Medical Sciences Udaipur, India Dr.Lokesh Singh Junior resident, Department of General Surgery, Pacific Institute of Medical Sciences, Udaipur, India Dr.Vishakha Agarwal Assistant Professor, Department of Pathology, Pacific Institute of Medical Sciences, Udaipur, India ABSTRACT Gastrointestinal stromal tumors (GIST) are highly frequent mesenchymaltumours of the digestive tract, which mainly affect the stomach and small intestine. GISTs frequently exist with unclear symptoms. Their initial clinical presentation as acute abdomen due to their perforation is particularly rare. We report a case of a 36- year-old male presenting with acute abdomen. The final diagnosis revealed a perforated GIST in the jejunum. In this paper, we report the clinical manifestation as well as computed tomography and histopathological findings helpful for the accurate diagnosis of this rare complication of GIST. Emergency laparotomy and resection of tumour are essential. Following surgical resection, adjuvant tyrosine kinase inhibitor therapy should be considered for prevention of early recurrence. KEYWORDS: Gastrointestinal stromal tumour, perforative peritonitis , spontaneous GIST perforation, jejunal GIST Received 24 July, 2021; Revised: 07 August, 2021; Accepted 09 August, 2021 © The author(s) 2021. Published with open access at www.questjournals.org I. INTRODUCTION Gastrointestinal stromal tumours (GIST) are mesenchymaltumours of the digestive tract that originate from interstitial Cajal cells and account for 0.1-3% of all gastrointestinal tumours. They are usually located in the stomach and small intestine [1], but they can be located anywhere in the gastrointestinal tract, including the omentum and peritoneum. Approximately 40% of GIST cases cause intestinal bleeding [2]. It occurs morecommonly in men with a median age of 50–70. GISTs are thoughtto be the result of mutations of proto- oncogene which encodes thecell surface tyrosine kinase receptor.Perforation is rarely observed in GISTs. We present a case of perforated GIST located in the jejunum as a rare cause of acute abdomen. II. CASE PRESENTATION A 36 year old male patient presented in the emergency with gradually increasing pain abdomen and vomiting for last four days. He did not have any prior surgical history and no known co-morbidity. There was no history of alcoholism or any other addiction either. Vitals were normal. On clinical examination there was generalised tenderness over the abdomen with rigidity and rebound tenderness. Bowel sounds were absent. A contrast CT Scan whole abdomen showed free air density in peritoneal cavity suggestive of pneumoperitoneum. Multiple irregular pockets of peritoneal collection with internal air density, hyper-density (hu-45 to 50) and enhancing walls -suggestive of peritonitis.