title: Laparoscopic management of obstructing small bowel GIST tumor.
abstract: BACKGROUND
  Gastrointestinal stromal (GIST) tumors make <1% of all gastrointestinal neoplasms and 20% of small bowel neoplasms. The most common acute presenting symptom of these tumors is gastrointestinal hemorrhage with obstruction being rare. We discuss our laparoscopic approach to 2 patients with small bowel GIST tumors that presented to our institution with obstruction of the small bowel.
  
  
  METHODS
  Two patients presented to the emergency department with signs and symptoms of small bowel obstruction. On workup, each was found to have a solid lesion either within or adjacent to the small bowel at the point of obstruction and both were emergently taken to the operating room. The pathologic diagnosis of small bowel GIST tumor was the same in both cases, but the pathophysiologies of the obstructing tumors were different.
  
  
  RESULTS
  Both patients underwent laparoscopic surgery with successful resection of the lesions. The details and crucial points of the laparoscopic approach to these tumors are described with specific attention to its appropriateness and safety in treating GIST tumors. Attention to particular details of the manipulation and management of the bowel in the face of obstruction and removal of the lesions is described.
  
  
  CONCLUSIONS
  The laparoscopic approach to GIST tumors of the small bowel, even in the face of emergent surgery, is a safe method.
authors.affiliation: Department of Surgery, LA State University Health Sciences Center, Earl K. Long Hospital, Baton Rouge, LA, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Morrison
authors.affiliation: 15715 Professional Plaza, Hammond, LA 70403, USA.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Hodgdon
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery*; D007580:Jejunal Neoplasms / Q000150:complications* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D055815:Young Adult