Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7816
Revised: August 26, 2013
Accepted: September 15, 2013
Published online: November 21, 2013
Processing time: 148 Days and 15.2 Hours
Gastrointestinal stromal tumor (GIST) is a rare mesenchymal tumor of the gastrointestinal tract that has been associated with the formation of fistulas to adjacent organs in few case reports. However, GIST with enterohepatic fistula has not been reported. Here we report the case of an enterohepatic fistula that occurred after embolization of a liver mass originating in the distal ileum. An 87-year-old woman was hospitalized for melena. On initial conventional endoscopy, a bleeding focus in the gastrointestinal tract was not found. Because of massive hematochezia, enteroscopy was performed through the anus. A protruding, ulcerative mass was found in the distal ileum that was suspected to be the source of the bleeding; a biopsy sample was taken. Electrocoagulation was not successful in controlling the bleeding; therefore, embolization was performed. After embolization, the patient developed a high fever and severe abdominal tenderness with rebound tenderness. Follow-up abdominopelvic computed tomography revealed an enterohepatic fistula between the liver and distal ileum. The fistula was treated surgically by segmental resection of the distal ileum and unlooping of the liver mass.
Core tip: Gastrointestinal stromal tumor (GIST) with fistula is a rare condition, however, it can be seen during treatment. Herein we report a case of an enterohepatic fistula that occurred after therapeutic embolization of liver mass originated from ileal GIST.