The occurrence of the pseudoaneurysm of visceral arteries in the field of chronic pancreatitis is a very rare complication that represents a life-threatening condition. The higher frequency of this complication is in the necrotic form of pancreatic inflammation, especially in patients with formed peripancreatic necrotic collections. The degradation of the arterial wall leads to bleeding and transforms these necrotic collections into a pseudoaneurysm. Urgent endovascular angioembolization is the first choice in the therapeutic approach as a valid minimally invasive solution with very satisfactory immediate and long-term outcomes. This successfully avoids open surgery, which is associated with a high mortality rate in these patients, especially in acute-on-chronic pancreatitis.

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors primarily located in the stomach and small intestine; their occurrence in the terminal ileum is particularly rare. Although GISTs can develop throughout the gastrointestinal tract, cases of perforation in elderly individuals are even less common, posing significant diagnostic and therapeutic challenges. This case report describes an 86-year-old male patient with an acute abdomen caused by a terminal ileum perforated GIST requiring urgent surgical intervention. An immunohistochemical examination of the tumor confirmed a GIST with a GILT (gastrointestinal leiomyogenic tumor) immunophenotype. The rarity of this condition makes it diagnostically challenging, as its symptoms are often nonspecific, and GISTs are frequently overlooked, particularly in older patients. This case supplements the existing literature by emphasizing the importance of considering GIST perforation in the differential diagnosis of an acute abdomen, even in elderly patients and in rare anatomical locations.

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors, primarily located in stomach and small intestine, while occurrence in the terminal ileum is particularly rare. Although GISTs can develop throughout the gastrointestinal tract, cases of perforation in elderly individuals are even less common, posing significant diagnostic and therapeutic challenges. This case report describes a 86-year-old male patient with an acute abdomen caused by a terminal ileum perforated GIST requiring urgent surgical intervention. Immunohistochemical examination of the tumor confirmed GIST with a GILT (gastrointestinal leiomyogenic tumor) immunophenotype. The rarity of this condition makes it diagnostically challenging, as symptoms are often nonspecific, and GISTs are frequently overlooked, particularly in older patients. This case underscores the importance of diagnostic features of this tumor and consideration of a wide differential diagnosis when assessing elderly patients presenting with suspected gastrointestinal perforation.

Acute gastrointestinal bleeding is a serious emergency condition which, without prompt and accurate diagnosis, can lead to severe hemorrhagic shock and death. The initial diagnosis relies on a clinical assessment of the bleeding site. If symptoms such as hematemesis and melena are present, an esophagogastroduodenoscopy (EGD) is typically the first diagnostic procedure. In cases of massive rectal bleeding, a computed tomography scan with angiography (CTA) is often used to identify the source and cause of the bleeding. Multiphasic CTA is the definitive first-line diagnostic standard, enabling prompt diagnosis and crucial pre-procedural planning for endovascular management in massive cystojejunal bleeding.

Acute gastrointestinal bleeding is a serious emergency condition which without prompt and accurate diagnosis can lead to severe hemorrhagic shock and death. The initial diagnosis relies on a clinical assessment of the bleeding site. If symptoms such as hematemesis and melena are present, an esophagogastroduodenoscopy (EGD) is typically the first diagnostic procedure. In cases of massive rectal bleeding, a computed tomography scan with angiography (CTA) is often used to identify the source and cause of the bleeding. multiphasic CTA is the definitive first-line diagnostic standard, enabling prompt diagnosis and crucial pre-procedural planning for endovascular management in massive cystojejunal bleeding.