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GIST-related malignant ascites with large-volume paracentesis complicated by myocardial infarction and tumour rupture
  1. Sade Hacking1,
  2. Karl Jackson1,
  3. Robert Johnston1,
  4. Eleanor Grogan2,
  5. Rowan Walmsley2,
  6. Leonie Armstrong2,
  7. Joanna Coleman2,
  8. Jennifer Grieve2,
  9. Sarah Robinson1,
  10. Katherine Frew2 and
  11. Avinash Aujayeb1
  1. 1 Acute Medicine and Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
  2. 2 Palliative Care Department, Northumbria HealthCare NHS Foundation Trust, North Shields, UK
  1. Correspondence to Dr Avinash Aujayeb, Northumbria Healthcare NHS Foundation Trust, North Shields NE29 8NH, UK; avinash.aujayeb{at}


This paper describes a patient with an inoperable gastrointestinal stromal tumour with moderate volume malignant ascites. A large-volume paracentesis caused haemodynamic instability and a myocardial infarction. An indwelling right-sided peritoneal catheter was inserted following further ascites build-up. The patient experienced spontaneous acute rupture of tumour and subsequent loculated ascites. An additional second catheter was inserted to the left side of the abdomen following reaccumulation of ascites following liquefaction of cyst contents and successful one-off drainage on the left side of abdomen. This is the first case report of a patient with two indwelling catheters: we describe learning points pertaining to those as well as the rupture of gastrointestinal stromal tumours. Haemodynamic instability after paracentesis in malignant-related ascites has also not been described

  • gastrointestinal (upper)
  • ascites

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  • Contributors AA, RJ, KJ and SH wrote the initial draft. SR, LA, JG, JC, KF, EG and RW revised the article and all authors agreed on the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.