The patient is on six months follow-up receiving oral imatinib 300 mg twice a day. Conclusion GIST was first described by Mazor and Clark (1983) [1]. It Selleck MAPK inhibitor originates from the interstitial

cells of Cajal (ICC), located in the muscularis propria (myenteric plexus) responsible for triggering smooth muscle contraction [2, 3]. The basic pathology is an activating mutation (gain in function) of chromosome 4 which codes for c-Kit resulting in uncontrolled proliferation of stem cells that differentiate towards ICC. GIST is sporadic [3]. Familial forms with autosomal dominant inheritance have also been documented [3, 4]. Isolated reports of GIST occurring concomitantly with paraganglioma, pulmonary chondroma, nerofibromatosis, pancreatic neuro-endocrine tumours, burkitt’s lymphoma, osteosarcoma, neuroblastoma and melanoma have been documented [4]. 90% of GIST occurs in adults more than 40 years of age (median age 63 years). There is slight male preponderance [4]. No documented elements indicating any association with geographic location, ethnicity,

race or occupation has been elucidated [4, 5]. The commonest site of GIST is stomach (60-70%) [2, 3]. Jejunum accounts for 10% of all GI tract GIST’s [1, 3]. Sporadic reports of GISTs arising from the omentum, mesentery or retroperitoneum, have been documented but most VS-4718 of these are metastatic from gastric or intestinal primaries [4]. Extra-GIST has been reported in gall bladder, pancreas, liver and urinary bladder [4]. Presentation is erratic. Seventy percent are symptomatic at presentation, 20% are asymptomatic and 10% are detected at autopsy [5, 6]. Common presentations include abdominal pain, palpable mass, gastro intestinal bleeding, fever, Liothyronine Sodium anorexia, weight loss and anaemia [7]. Isolated jejunal GIST associated with perforation

and peritonitis is a rare and unique [1]. Perforation is usually attributed to replacement of bowel wall by tumour cells, tumour embolization leading to ischemia, necrosis together with raised intra-luminal pressure [4, 5, 7]. In view of the exophytic nature of the growth, intestinal obstruction occurs due to compression rather than luminal obstruction. As such intetstinal obstruction is a rare occurrence until the tumour attains enormous size. Clinical diagnosis of GIST is based on index of suspicion [6, 7]. Specific diagnostic signs and symptoms are absent. Chronicity is a rule. Acute atypical presentation includes hemorrhage and perforative peritonitis [1–10]. Preoperative imaging modalities like contrast enhanced abdominal computerized tomography (CT) aids in diagnosis [8]. The extent of the tumor, metastases and involvement of other organs can be assessed. A dedicated magnetic resonance imaging (MRI) provides better information than CT in the preoperative staging workup [7, 8]. Endoscopy can diagnose gastric GISTs. Endoscopy demonstrates smooth, mucosa-lined protrusion of the bowel wall which may or may not show signs of bleeding or ulceration.