P0970 - Disseminated Kaposi Sarcoma Presenting as a Small Bowel Obstruction: A Rare Entity

Herman S. Suga, DO¹, Neethi R. Dasu, DO², Yaser Khalid, DO³, Kirti Dasu, BS⁴, Lucy Joo, DO⁵, Judith Lightfoot, MD^6
1Rowan University School of Osteopathic Medicine, Jefferson Health NJ, Laurel Springs, NJ; ²Rowan University School of Osteopathic Medicine, Jefferson Health NJ, Voorhees Township, NJ; ³Wright Center for Graduate Medical Education, Davie, FL; ⁴Syarcuse University, Stratford, NJ; ⁵Thomas Jefferson University Hospital, Cherry HIll, NJ; ⁶Rowan University School of Osteopathic Medicine, Stratford, NJ

Introduction: Kaposi’s Sarcoma (KS) is the most common neoplasm associated with AIDs. Less than 4% of cases involve the gastrointestinal (GI) tract. Patients usually present with skin manifestations, and in rare cases involve the GI tract. We present a case report of a young African American male who presented with a small bowel obstruction and was found to have KS.

Case Description/Methods: A 24 year old male with a history of cutaneous Kaposi Sarcoma, HIV, SIADH, adrenal insufficiency, and recurrent GI bleeding presented to the hospital for evaluation of abdominal pain and intermittent dysphagia. On physical exam: he appeared frail, cachetic, with a distended abdomen: Lab work showed significant transaminitis and elevated AST and ALT. He underwent a CT scan with contrast revealed a small bowel obstruction diffuse and anasarca. He underwent an exploratory laparotomy which showed a small bowel obstruction in the distal ileum secondary to intussusception, and subsequent small bowel resection. His hospital course was complicated by septic shock, disseminated intravascular coagulopathy, ventilator dependent respiratory failure with eventual tracheostomy. He developed an ileus and a CT scan revealed narrowing in the sigmoid colon. GI did not perform a colonoscopy as they did not suspect a mass. A dobhoff was eventually placed for nutrition. Surgical Pathology of the distal ileum revealed a submucosal neoplasm consistent with Kaposi Sarcoma.

Discussion: The clinical presentation of Kaposi's Sarcoma is variable. Advanced lesions can manifest as: GI bleeding, protein-losing enteropathy, chronic diarrhea, intussusception, obstruction, or even perforation. Given the wide variety of presentations, it is important for clinicians to have a broad differential with patients who have KS and recurrent abdominal pain. Kaposi's Sarcoma rarely involves the GI tract which can make it challenging to diagnose. Currently, there is no current consensus on endoscopic screening guidelines to evaluate Kaposi Sarcoma of the GI tract. Thus further studies are needed in this patient population in order to decrease complications.


Disclosures:


Herman S. Suga, DO¹, Neethi R. Dasu, DO², Yaser Khalid, DO³, Kirti Dasu, BS⁴, Lucy Joo, DO⁵, Judith Lightfoot, MD⁶. P0970 - Disseminated Kaposi Sarcoma Presenting as a Small Bowel Obstruction: A Rare Entity, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.