Gastric gastrointestinal stromal tumour causing a gastroduodenal intussusception

We present the case of a 63 year old woman from Bangladesh, who presented with history suggestive of gastric outlet obstruction for 1 year and melena for 2 weeks. She was previously treated at her hometown for pancreatic pseudocyst. At presentation she was cachexic, anaemic and icteric. She was diagnosed to have a gastric antral polyp causing gastro-duodenal intussusception. This caused gastric outlet obstruction (GOO), obstructive jaundice and pancreatic duct dilatation. In spite of her frail and nutritionally depleted state she needed emergency laparotomy to prevent complications of cholangitis and severe melena. She had relief of symptoms post operatively. The challenges in perioperative management of this rare scenario in a frail, 63 year old woman are described.