Ball-Valve Syndrome, an Unusual Presentation of a GIST

We present the case of an 87-year-old woman admitted to the emergency room due to persistent vomiting in the previous 4 days. She also complained of an intermittent abdominal pain and a weight loss of 10 kg with months of evolution. On physical examination, she had audible bowel sounds, painful palpation in the epigastrium without signs of peritoneal irritation. The laboratory panel showed only isolated neutrophilia, and the abdominal X-ray had no evidence of bowel distension. The pathological specimen was compatible with a 4 × 3.2 cm gastrointestinal stromal tumor (GIST), with a low mitotic index (1/50 HPF), suggestive of a low-risk tumor by the modified National Institute of Health classification [1] (Fig. 4). The clinical manifestations are variable according to the degree of obstruction, ranging from abdominal discomfort or intermittent abdominal pain, nausea, vomiting and loss of appetite.