Fístula interna ileoileal congénita que debuta como un cuadro obstructivo en el adulto / Intestinal obstruction caused by a congenital ileo-ileal internal fistula

Background: Among congenital malformations of the digestive tract, internal congenital fistulas tend to be associated with multiple malformations. Case report: We report a previously healthy 32 years old male consulting for abdominal pain and vomiting lasting 48 hours. A plain abdominal film show small bowel dilatation and air-fluid levels. The patient was operated with the diagnosis of bowel obstruction. During the operation dilated bowel loops trapped in a congenital ileo-ileal fistula were found. No biopsies were obtained. The patient had an uneventful postoperative evolution.

Introducción: Las malformaciones congénitas del aparato digestivo pueden ser muy variadas. En caso de presentar síntomas, suelen aparecer en las primeras etapas de la vida con un amplio abanico de manifestaciones clínicas dependiendo del segmento al que afecte y de la complejidad de las malformaciones. Sin embargo, hay muy pocas fístulas internas congénitas recogidas en la literatura médica y la mayoría suelen estar relacionadas con malformaciones múltiples. Caso clínico: Presentamos un situación muy poco frecuente. Se trata de un caso de fístula interna congénita que debutó con un cuadro obstructivo agudo como único síntoma en un adulto.

A Case of Malignant Gastrointestinal Stromal Tumor of Ileum with Liver Abscess / 대한소화기학회지

Gastrointestinal stromal tumor (GIST) is an uncommon mesenchymal tumor of the gastrointestinal tract and is generally located in the stomach and small intestine. They usually present with abdominal pain, gastrointestinal bleeding, and palpable mass. Some patients present with rare symptoms that are more common in malignant GIST. Malignant GIST combined with a liver abscess has not been reported yet in the literatures. We report a case of 67-year-old woman who suffered from liver abscess combined by malignant GIST with central necrosis and fistula in the ileum. She complained of fever, chills, and abdominal pain. Abdominal CT scan showed huge liver abscess and ileal mass with air pocket. Small bowel series showed contrast material filling into the ileal GIST mass. An operation was performed and the final diagnosis was malignant GIST of the ileum with invasion into the sigmoid colon and urinary bladder.