Distal duodenectomy for a gastrointestinal stromal tumour

Aim-Background We report the case of a 55-year-old female with a GIST of the duodenum successfully managed by excision of the third and fourth portion of the duodenum. Duodenal gastrointestinal stromal tumours (GISTs) are very rare and constitute only 3–5% of all GISTs. There is some controversy as to whether they should be treated by a pancreatoduodenectomy or by a limited resection of the duodenum. Case presentation A 55-year-old female with a seven-year history of iron deficiency anaemia and intermittent episodes of rectal bleeding was referred to our unit with a diagnosis of duodenal GIST. She underwent a laparotomy through a bilateral subcostal incision and a distal duodenectomy with end-to-end duodenojejunal anastomosis was performed. The patient made an uneventful recovery and was discharged on the 8th post-operative day. Nineteen months after surgery she is disease-free. Conclusion Advances in surgical technique and a better understanding of the natural history of gastrointestinal stromal tumours pave the way for the acceptance of more limited resections. Avoiding the complications of a major resection, partial duodenectomy is preferable over pancreatoduodenectomy when technically feasible.