Combined lesser curvature gastrointestinal stromal tumor excision and sleeve gastrectomy in a bleeding obese patient: a case report

Abstract

Gastrointestinal Stromal Tumors (GIST) are the most frequent submucosal lesions encountered in the gastrointestinal tract. Once encountered in the stomach, they pose several challenges in resection based on their location. Some reports have observed an increased occurrence of GISTs in obese patients, however, a correlation has not been established. Some cases of fundus Gastrointestinal stromal tumor excision during sleeve gastrectomy en-mass have been reported, however, lesser curvature GIST pose a unique challenge of fashioning the sleeve. We highlight a challenging case of excising a GIST involving the lesser curvature, followed by a sleeve gastrectomy involving the greater curvature which resulted into a unique challenge of ensuring a proper anatomical low-pressure sleeve, following endoscopic calibration. Laparoscopic excision of a gastrointestinal stromal tumor and sleeve gastrectomy involving different anatomical regions of the upper stomach can be safely performed, even in our settings, despite the challenges of fashioning a low-pressure vertical sleeve.