FIGURE 1.4.2 Ulcerated small bowel GIST. Contrast-enhanced CT image (
A) shows a heterogeneous abdominal mass
with a large central crater that contains air and oral contrast from ulceration. US image (
B) from a different patient
shows a large soft tissue mass with a central anechoic cavity from necrosis and ulceration. Image from push
enteroscopy (
C) from a third patient shows a large ulcerated mass. The exoenteric component cannot be assessed by
luminal examination. Image from capsule endoscopy (
D) from a fourth patient shows a polypoid GIST with central
ulceration. CT image (
E) from a patient with an acute GI hemorrhage shows a polypoid jejunal lesion (arrowhead).
At capsule endoscopy (
F), an ulcerated mass with evidence of active bleeding was seen, which was confirmed at
subsequent push enteroscopy (
G); note the ulcerated portion of the mass that appears dark red. Endoscopic biopsy
was nondiagnostic, but a GIST was confirmed at surgery. Contrast-enhanced CT images (
H and
I) from a patient with
obscure GI bleeding show a large ulcerated small bowel GIST with associated hepatic metastatic disease.
