A 67-year-old hypertensive patient, with no history of gastroduodenal ulcus or ingestion of gastrolesive drugs, presented to the emergency department with melena and progressive fatigue for about two weeks.
Analytical analysis showed the presence of Hb levels of 9.8, with normal blood pressure and acceptable general status with negative rectal examination.
An upper endoscopy showed a large gastric submucosal lesion found in ulcerated fundus located in its center due to a fibrinous bottom without signs of current or recent active bleeding.
It was interpreted as ulcerated gastric submucosal lesion most likely leiomyomatous responsible for digestive bleeding.
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A radial echoendoscopy confirmed the submucosal nature of this lesion, depending on the fourth layer of the gastric wall (muscularis propria), hypoechogenic, homogeneous, with delimited edges and maximum diameter of 4.6 x 3.4 cm.
Its border on the face of the gastric lumen presented an explantation secondary to an ulcer of about 2 cm in size.
No perilesional or celiac trunk lymphadenopathy was observed.
The echoendoscopic diagnosis of stromal submucosal gastric tumor ( GIST tumor) of probable muscular strain was made.
With this diagnosis and due to the endoscopic criteria of size (4 cm) and hemorrhagic complication, elective treatment was performed by resection and enucleation of the lesion.
The histological study of the resected piece resulted in gastric emptying.
