Gastrointestinal stromal Tumors: A rare cause of upper gastrointestinal bleeding in Rivers State University Teaching Hospital

Gastrointestinal stromal tumours (GIST) are mesenchymal tumours originating from the intestinal cells of Cajal. They are a known cause of upper gastrointestinal bleeding but this is a rare feature. Patients present with melena (black tarry stools), haematemesis (vomiting of blood) or unexplained iron deficiency anaemia due to chronic slow blood loss. As the tumour enlarges, the submucosal tumour outgrows its blood supply leading to pressure necrosis, ulceration of overlying mucosal layer and direct vessel erosion. We report on 3 cases, first case is a 71-year-old male diabetic who had history of 2 simultaneous episodes of haematemesis, melena and significant history of non-steroidal anti-inflammatory drug use for an injury, upper GI endoscopy a polypoid mass about 8 to 10cm with a broad base and areas of ulceration with a pool of blood at the fundus. The second case is a 49-year-old female, hypertensive known chronic dyspeptic patient with a history of haematemesis, melena, upper gastrointestinal endoscopy revealed a cauliflower mass on the fundus of the stomach with widespread salt and pepper appearance. The third case is a 53-year-old male who presented with haematemesis, melena, history of chronic NSAID use, upper GI endoscopy revealed a gastric mass suspicious of GIST. Surgery was done in all cases and patients have good recovery on follow up.