Answer

From question on page 1493

Small bowel radiography revealed a large mass dislodging and compressing the bowel towards the inferior quadrants of the abdomen. No evidence of infiltration by the tumour was detected.

At laparotomy, a large tumour originating from the anastomotic ileal loop was resected en bloc. Surprisingly, histology showed the presence of a GIST. The tumour developed from connective tissue of the peri-anastomotic ileal loop. At this site, histological signs of Crohn’s recurrence were also present.

This is the second case reported in the literature of GIST occurring in a patient with Crohn’s disease. Many types of non-adenocarcinoma tumours have been reported to significantly affect patients with Crohn’s disease but this occurs only in a small number of patients. However, attention should be paid to the association of small bowel tumours such as GIST and Crohn’s disease due to the increased difficulty of diagnosis with non-specific symptoms.