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Had GIST At DJ Junction. Having Ulcer. Safe Remedy And Medical Cure For This?
HI sir,i want to ask abt my mom's problem.her name is mrsMEENA VERMA and age is 52 yrs.she had GIST at DJ junction, for that she was operated 3 yrs back.after this surgery she had abcess at the drain site which was very deep and got heal after 2 months.she was on imatinib.after that she had severe colicky pain nd investigation reveal that adhesion between abdominal wall nd intestine occurs nd luemen of intestin get constricted.nd there was fistula between intestine nd abdominal wall.nd this occur at the site of previous abcess.it occurs after 2 yrs of healing of abcess.for that she was again operated nd excission of afected part nd anastamosis done.after 5 months of surgery she has severe decrease in Hb.she has 5gm% Hb.nd wih in a month there was 2gm Hb was reduced.nd after endoscopy ulcer at operation site was revealed.biopsy done nd report is normal.3 unit blood transfusion done.after that rate of reduction ofHb is decreased.during this sha was taking oral iron but now despite of oral iron therapy again Hb heamoglobin reduce from 9.5gm% to 7.5gm%.now imatinib is dicontinue because of ulcer.sir m worried about her.what could be the cause of this ulcer nd how it will get heal.please please sir i m requesting u please tell me the probable cause nd what we should do to overcome this problem.
Thu, 9 May 2013
Hello!
Thank you for the query.
You have not mentioned very important data like: where was the ulcer located (stomach, small intestine, large intestine?). Where were the GIST located (DJ junction of what?)
If the ulcers are present in the stomach, small intestine and are hardly treatable, it is necessary to rule out Zollingers-Ellisons syndrome. This is caused by a tumor which keeps secreting gastrine hormone. Ulcers and diarrhea are characteristic for this syndrome.
GIST recurrence and metastases should be also considered. It can also give bleeding ulcers, hemoglobin lost.
If the ulcers are in the large intestine inflammatory bowels diseases (like Crohns disease or Ulcerative Colitis) should be also considered.
It is advisable to have some tests. Colonoscopy, gastroscopy, abdominal CT should be done at first. ANA and ANCA antibodies, gastrine level should be checked. For possible metastases, PET seems to be reasonable.
Hope you will find it helpful.
Regards.
Thank you for the query.
You have not mentioned very important data like: where was the ulcer located (stomach, small intestine, large intestine?). Where were the GIST located (DJ junction of what?)
If the ulcers are present in the stomach, small intestine and are hardly treatable, it is necessary to rule out Zollingers-Ellisons syndrome. This is caused by a tumor which keeps secreting gastrine hormone. Ulcers and diarrhea are characteristic for this syndrome.
GIST recurrence and metastases should be also considered. It can also give bleeding ulcers, hemoglobin lost.
If the ulcers are in the large intestine inflammatory bowels diseases (like Crohns disease or Ulcerative Colitis) should be also considered.
It is advisable to have some tests. Colonoscopy, gastroscopy, abdominal CT should be done at first. ANA and ANCA antibodies, gastrine level should be checked. For possible metastases, PET seems to be reasonable.
Hope you will find it helpful.
Regards.
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