title: Gastrointestinal stromal tumour (GIST) presenting as a strangulated inguinal hernia with small bowel obstruction.
abstract: Gastrointestinal stromal tumours (GISTs) can arise everywhere along the gastrointestinal (GI) tract. Their presentation in unusual locations should always be taken into account. A 74-year-old man referred to the emergency department for small bowel obstruction caused by an incarcerated inguinal hernia. A CT scan showed a mesenchymal tumour originating from the herniated bowel loop and a mass in the ascending colon. Laparoscopic resection of the mass and laparoscopic right hemicolectomy were performed. The histology showed a ruptured GIST arising from the herniated small bowel and a high-grade dysplasia villous adenoma of the right colon. GISTs can present with symptoms spanning from vague abdominal discomfort to surgical urgencies. Strangulated hernia is an extremely rare presentation, with only two cases described in the literature. A safe surgical approach was obtained with laparoscopy, maintaining surgical radicality. The ileal localisation and the pseudocapsule rupture were the main risk factors on prognostic stratification.
authors.affiliation: Regional Center for HPB Surgery, Regional Hospital of Treviso, Treviso, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Massani
authors.affiliation: Department of Surgical Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Capovilla
authors.affiliation: Regional Center for HPB Surgery, Regional Hospital of Treviso, Treviso, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Ruffolo
authors.affiliation: Regional Center for HPB Surgery, Regional Hospital of Treviso, Treviso, Italy.|Department of Surgical Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Bassi
mesh_terms: D018253:Adenoma, Villous / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000368:Aged; D003082:Colectomy; D003110:Colonic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006552:Hernia, Inguinal / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007078:Ileal Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed