G.I.S.T.

CASE
ED B Y : D R. HASSANAIN TALIB
SUPERVIS
PATIENT DATA
• K. A.
• 67 YRS OLD
• MALE , MARRIED
• LIVE IN BAGHDAD
• PMH : HTN
• PSH : BULLET INJ. WITH SPLENECTOMY & COLOSTOMY BEFORE 37 YRS
PT COMPLAINING

• BLACK TARRY STOOL FOR 1 MONTH DURATION

CASE SCENARIO

• The condition started before 1 MONTH as a repeated attacks of painless

Bleeding per rectum , malena and tiredness

• He was given blood transfusion multiple times during a previous admission

• on adm. Hb was 6.5 then received 5 pint of blood and sent for OGD
O.G.D SHOWED 2 MASSES

•1 ST
: ulcerated mass in lesser curvature of distal part of stomach

•2 nd
: mass in distal post gastric wall not ulcerated
CT SCAN
DECIDED FOR ELECTIVE LAPAROTOMY

• Identification of large mass adherent to liver , protruding from ant wall of

stomach , adhesions released

• Dissection of greater and lesser curvature

• Distal gastrectomy done , gastrojujunostomy done
• 2 drains inserted ( pelvic and lt. subphrenic )
• Specimen sent for histopathology
POST-OP

• Pt was stable , bleeding subsided

• On Day 3 started oral fluid
• On day 5 patient discharged
HISTOPATHOLOGY
THANK YOU