Ruptured jejunal gastrointestinal stromal tumor (GIST) presenting with acute hemoperitoneum in a young adult with autosomal dominant polycystic kidney disease (ADPKD)

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms of the gastrointestinal tract, most commonly arising in the stomach and less frequently in the small intestine. Jejunal GISTs often present with vague symptoms, leading to delayed diagnosis, while acute presentations with hemodynamic instability are uncommon and usually result from tumor necrosis or rupture. We report a 37-year-old man with autosomal dominant polycystic kidney disease who presented with acute abdominal pain and shock requiring immediate resuscitation and intensive care admission. Ultrasonography revealed free intraperitoneal fluid and a vascular suprapubic mass. On contrast enhanced computed tomography a heterogeneous necrotic tumor with mesenteric fat stranding and free fluid was identified. Emergency laparotomy identified a hemorrhagic jejunal tumor with hemoperitoneum, which was resected en bloc with primary anastomosis. Histopathology confirmed a moderate-risk GIST. Early radiologic localization and prompt surgical intervention were lifesaving.