A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract and expresses CD117, a c-kit proto-oncogene, which can be detected immunohistochemically. We reported a GIST of the rectum of a 61-year-old-woman who had visited emergency room complaining of constipation over one week. Upon rectal examination, a round hard mass was palpated. Colonoscopy showed a 7×5 cm sized protruded lesion with surface ulceration on a rectum, adjacent the anus. And abdomen computed tomography revealed the soft tissue mass compressing anterolateral wall of the rectum and these findings suggest possibility of rectal submucosal tumor such as GIST. The patient had been treated with a ultra anorectal anastomosis with loop ileostomy. Immunohistochemical studies on the surgically resected specimen showed c-kit (+) and CD34 (+). The final diagnosis was a GIST of the rectum. She was grouped into high risk and she has been given adjuvant chemotherapy with Imatinib.

Ingestion of corrosive substances can produce severe injury to the gastrointestinal tract and can even result in death in the acute phase. The extent and degree of damage depends on the type and amount of substances. There are occasional reports of severe contiguous injury to the esophagus and stomach caused by strong alkali ingestion in the acute phase. Usually the deaths occur within a couple of days due to multi-organ failure after ingestion of relatively much amount of agent for a suicidal attempt. But death due to late progression is very rare.

We have reported a case of 60-year-old female patient who was diagnosed as corrosive esophagitis after accidental ingestion of strong alkali. Initial endoscopic findings were compatible with IIa-IIa-0(according to Zargar's classification) in the esophagus, stomach and duodenum, respectively. After several weeks of supportive care, her subjective symptoms were much improved during she had been wating for the operation of colon interposition due to esophageal stricture. Metabolic acidosis and thrombocytopenia developed abruptly probably due to upper gastrointestinal tract necrosis and she died when 60 days had passed after the occurrence of initial esophageal injury.

Citations

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• A Case Report of Gastroesophageal Reflux Disease and Dysphagia Caused by Ingestion of Detergent
  Young-ji Kim, Jeong-su Park, Hyun-kyung Sung, Ju-ah Lee, Dam-hui Kim, Ho-yeon Go, Kyung-hwan Kong
  The Journal of Internal Korean Medicine.2016; 37(5): 855.     CrossRef