P3298 - Overcoming Diagnostic Challenges: Advanced Enteroscopy in the Detection and Management of Gastrointestinal Stromal Tumors in Minority Populations

Edgardo A. Arevalo Lopez, MD¹, Gabriela Bedolla Carriedo, MD², Irene Maria Guadalupe. Arevalo Soto, MD, MSc³, Sylvia Preciado, MD, MSc¹, Bernardo Donery Lopez Samayoa, MD^4
1Huntington Memorial Hospital, Pasadena, CA; ²Universidad Michoacana de San Nicolas de Hidalgo, Redlands, CA; ³Universidad de El Salvador/Universidad Europea del Atlantico, Los Angeles, CA; ⁴Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Introduction: Gastrointestinal Stromal Tumor (GIST) located in the small intestine, is frequently under-diagnosed due to its nonspecific symptoms and the limitations of conventional diagnostic methods. This issue is compounded by the challenges faced by minority populations, who often encounter barriers to timely and effective medical care. Double-Balloon Enteroscopy (DBE), have improved the detection of this tumor, but their utilization is not always immediate or widespread, leading to prolonged diagnostic timelines.

Case Description/Methods: A 58-year-old Hispanic female with a history of hypothyroidism and dyslipidemia presented with low gastrointestinal bleeding and iron deficiency anemia. From 2012 to 2014, she experienced multiple episodes of melena, leading to several hospitalizations and extensive, yet inconclusive, endoscopic evaluations.

In February 2014, after another melena episode, a retrograde double-balloon enteroscopy (R-DBE) which confirmed a deeply ulcerated, friable, necrotic-appearing mass in the mid-ileum an ulcerated apple-core lesion in the mid-ileum. Biopsies were taken, and the lesion was marked for surgery. Surgical resection was performed, and a 10 cm mass was removed from the mid-jejunum. Pathological analysis confirmed the mass as GIST, measuring 10x8.5x7.5 cm.

Postoperatively, she tolerated a liquid diet, discontinued pain medications, and had regular bowel movements. She reported significant improvement.

Discussion: Practitioners should consider early use of advanced diagnostic tools like DBE in patients with unexplained gastrointestinal bleeding. Conventional methods may miss diagnoses such as GISTs, whereas DBE can accurately identify and localize lesions, leading to effective surgical intervention and symptoms relief. Ensuring equitable access to advanced diagnostics and timely specialist referrals are essential for improving health outcomes in these groups.


Disclosures:


Edgardo A. Arevalo Lopez, MD¹, Gabriela Bedolla Carriedo, MD², Irene Maria Guadalupe. Arevalo Soto, MD, MSc³, Sylvia Preciado, MD, MSc¹, Bernardo Donery Lopez Samayoa, MD⁴. P3298 - Overcoming Diagnostic Challenges: Advanced Enteroscopy in the Detection and Management of Gastrointestinal Stromal Tumors in Minority Populations, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.