{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:25:45Z","timestamp":1791195945952,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T00:00:00Z","timestamp":1749254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T00:00:00Z","timestamp":1749254400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Gastrointestinal stromal tumors (GISTs) are vascular tumors that can cause significant gastrointestinal hemorrhage. While endoscopic treatment is common for other hemorrhagic disorders, its role in GIST\u2010related hemorrhage remains unclear. This study presents a case series of five patients who underwent successful endoscopic hemostasis for upper gastrointestinal GISTs and explores potential risk factors for hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center retrospective study included patients diagnosed with upper gastrointestinal GISTs between January 2013 and December 2022. Of the 61 eligible patients, the clinical courses of five patients who underwent endoscopic hemostasis were reviewed. In addition, an exploratory analysis was conducted to identify risk factors associated with GIST\u2010related hemorrhage by comparing hemorrhagic and non\u2010hemorrhagic groups using univariate analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five patients underwent successful endoscopic hemostasis using hypertonic saline\u2010epinephrine injection and\/or clipping for hemorrhage from exposed vessels at the ulcer. Consequently, emergency surgery within 24\u00a0h was avoided in all cases, and elective surgery was conducted between 7 and 51 days. Additionally, ulcer formation (odds ratio [OR] 37.20; 95% confidence interval [CI] 2.40\u2013582.00;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01), elevated white blood cell count (OR 1.05; 95% CI 1.01\u20131.09;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03), and elevated body mass index (OR 1.22, 95% CI 1.02\u20131.47,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03) were identified as risk factors for hemorrhage in the exploratory analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopic hemostasis may help avoid emergency surgery in GIST\u2010related hemorrhage when hemorrhage points are clearly visualized. Ulceration may serve as a predictive factor for hemorrhage; therefore, early surgical intervention should be considered in GISTs with ulceration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70158","type":"journal-article","created":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T13:55:02Z","timestamp":1749304502000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Endoscopic Hemostasis for Gastrointestinal Stromal Tumor Hemorrhage: A Case Series and Retrospective Analysis of Risk Factors"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3059-495X","authenticated-orcid":false,"given":"Karen","family":"Kimura","sequence":"first","affiliation":[{"name":"Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-7371","authenticated-orcid":false,"given":"Chikamasa","family":"Ichita","sequence":"additional","affiliation":[{"name":"Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Sumida","sequence":"additional","affiliation":[{"name":"Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Nishino","sequence":"additional","affiliation":[{"name":"Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Nagayama","sequence":"additional","affiliation":[{"name":"Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-018-1532-1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21120"},{"key":"e_1_2_11_4_1","first-page":"93","article-title":"Gastrointestinal Stromal Tumor: 15\u2010Years' Experience in a Single Center","volume":"14","author":"Wang M.","year":"2014","journal-title":"BMC Surgery [Electronic Resource]"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v5.i6.102"},{"key":"e_1_2_11_6_1","first-page":"888","article-title":"Clinicopathological Features of Hemorrhagic Gastrointestinal Stromal Tumor","volume":"117","author":"Sakamoto K.","year":"2020","journal-title":"Journal of Japanese Society of Gastroenterology"},{"key":"e_1_2_11_7_1","first-page":"875","article-title":"A Case of Duodenal Gastrointestinal Stromal Tumor (GIST) With Pancreatic Head Invasion Successfully Treated by Pancreaticduodenectomy After Transcatheter Arterial Embolization (TAE)","volume":"33","author":"Yamamoto T.","year":"2013","journal-title":"Journal of Abdominal Emergency Medicine"},{"key":"e_1_2_11_8_1","first-page":"675","article-title":"A Case of a Small Gastrointestinal Stromal Tumor of the Stomach With Gastric Hemorrhage","volume":"29","author":"Yamashita S.","year":"2009","journal-title":"Japanese Society for Abdominal Emergency Medicine"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/15330338211034259"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-06816-9"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_2_11_12_1","first-page":"2450","article-title":"A Case of Gastrointestinal Stromal Tumor of the Duodenum Resected After Transcatheter Arterial Embolization","volume":"66","author":"Okada K.","year":"2005","journal-title":"Journal of the Japan Surgical Association"},{"key":"e_1_2_11_13_1","first-page":"441","article-title":"Gastric Stromal Tumor: A Rare Cause of Upper Gastrointestinal Bleeding","volume":"16","author":"Szanto P.","year":"2007","journal-title":"Journal of Gastrointestinal and Liver Diseases"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1272\/jnms.75.306"},{"key":"e_1_2_11_15_1","first-page":"553","article-title":"A case of Gastrointestinal Stromal Tumor (GIST) With Gastrointestinal Bleeding in which Transcatheter Arterial Embolization (TAE) was Useful","volume":"31","author":"Wakata K.","year":"2011","journal-title":"Japanese Society for Abdominal Emergency Medicine"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2342\/ymj.65.137"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-12-89"},{"key":"e_1_2_11_18_1","first-page":"1160","article-title":"A Clinicopathological Study of Bleeding Gastric Ulcer","volume":"14","author":"Machida T.","year":"1981","journal-title":"Japanese Journal of Gastroenterological Surgery"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200206000-00003"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70158","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70158","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:58:19Z","timestamp":1790171899000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,7]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/deo2.70158"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70158","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,7]]},"assertion":[{"value":"2025-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70158"}}