Successful treatment with laparoscopy-assisted surgery for ileal perforation due to an ingested foreign body: A report of two cases.

INTRODUCTION: Presently, the advantage of laparoscopic surgery is widely recognized and it is gaining popularity not only in elective abdominal surgeries but also in various kinds of emergent abdominal surgeries. This report describes two patients diagnosed with ileal perforation due to an ingested foreign body (FB)-a rare abdominal emergency-who were treated laparoscopically. PRESENTATION OF CASE: Both patients were brought in by an ambulance to our hospital, with complaints of increasing lower abdominal pain. Computed tomography scan revealed a small bowel perforation due to an ingested FB in both patients, and laparoscopy-assisted partial ileal resection was immediately performed. Their postoperative recoveries were uneventful. DISCUSSION: Both patients with this rare abdominal emergency were successfully treated with laparoscopic surgery. Its feasible diagnostic and therapeutic abilities and decreased invasiveness contributed to their uneventful and fast recoveries. Extracorporeal handling of the affected small bowel via mini-laparotomy was useful in this setting as it was safe, fast, and cost-effective. CONCLUSION: Laparoscopic surgery is effective, even for this rare abdominal emergency. Moreover, laparoscopy-assisted surgery accompanying mini-laparotomy is a rational treatment approach, especially for this condition.

A gastrointestinal stromal tumor of the jejunum presenting with an intratumoral abscess: A case report and a literature review.

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. The small intestine is the second-most frequent location where GISTs occur after the stomach. Attention should be paid to small intestinal GISTs because they infrequently present with acute abdomen, which necessitates emergency surgery. This report describes a patient with a small intestinal GIST developing a giant intratumoral abscess, in whom emergency surgery was performed. PRESENTATION OF CASE: A 56-year-old woman presented with worsening abdominal pain. Computed tomography scan showed an approximately 9.5 cm × 9 cm tumor bearing a thick and hypervascularized wall with an internal air-fluid level. Emergency laparotomy revealed the tumor originated from the jejunum, and partial resection of the jejunum was performed. A large amount of pus was contained inside the tumor. Immunohistochemically, the tumor was diagnosed as a high risk GIST of the Cjejunum, and imatinib mesylate was initiated. DISCUSSION AND CONCLUSION: When an intratumoral abscess in the abdomen is confirmed, GISTs should be listed as differential diagnosis. Complete surgical resetcion with careful handling and adjuvant chemotherapy with imatinib mesylate are considered to be important for this state.