Unusual Etiology of Epigastric Pain

• Published in: The Journal of emergency medicine Vol. 40; no. 5; pp. e93 - e95
• Main Authors: Slim, Rita, MD, Smayra, Tarek, MD, Tohme, Cyril, MD, Samaha, Elia, MD, Yaghi, Cesar, MD, Sayegh, Raymond, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2011
• Subjects: Abdominal Pain - diagnosis; Abdominal Pain - surgery; Diagnosis, Differential; Emergency; epigastric pain; Gastrointestinal Stromal Tumors - diagnosis; Gastrointestinal Stromal Tumors - surgery; GIST; Humans; Laparotomy; Male; Middle Aged; Stomach Neoplasms - diagnosis; Stomach Neoplasms - surgery; Tomography, X-Ray Computed; torsion; Torsion Abnormality - diagnosis; Torsion Abnormality - surgery; epigastric pain; torsion; GIST
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2007.11.111

Abstract Background: Epigastric pain is a common presenting complaint encountered in urgent care settings. Although peptic, biliary, and pancreatic pathologies are the most frequent findings, other rare diagnoses also can be found. Objectives: We report an unusual case of acute epigastric pain in which abdominal ultrasound was of great support in revealing the diagnosis. Case Report: A 64-year-old man presented to the Emergency Department after rapid onset of acute epigastric pain. Abdominal ultrasound showed a multi-cystic heterogeneous mass between the stomach and the liver. Abdominal computed tomography scan confirmed the gastric origin of the mass and showed torsion signs. Urgent laparotomy was performed with tumor excision. The diagnosis of pedunculated exophytic gastric stromal tumor was made and long-term follow-up was arranged. Conclusions: Acute presentation revealed the presence of the tumor, which was excised surgically.