Minimally invasive experience for the treatment of gastrointestinal stromal tumours.

Gastrointestinal stromal tumours are rare mesenchymal neoplasms, accounting less than 3% of all the gastrointestinal tumours, that may arise in all portions of the gastrointestinal tract but more frequently they involve stomach and small bowel. Generally are asymptomatic or slight symptomatic, although they may also cause acute clinical conditions. Histologically are characterised by a meshwork of spindle-like cells mixed with fibro-hyaline stroma. The immunohistochemical assessment, marked for a strong immunopositivity for CD117 antibodies, allows the differential diagnosis with others muscular, nervous and fibroblastic tumours. Tumour size and mitotic rate are the most important prognostic indicators. Surgery represents the treatment for patients with primary non-metastatic disease, however a prolonged oncologic follow-up is always recommended. Minimally invasive technique is increasingly adopted and preferred for its low morbidity and shorter in-hospital stay, and more and more reports confirm its safety, efficacy and feasibility. We report a case series of three pauci-sympomatic patients, all hospitalised for severe anaemia related to a chronic gastrointestinal bleeding, successfully treated by laparoscopic approach for the removal of gastrointestinal stromal tumours, two located in the stomach and one in the jejunum.

Atraumatic splenic rupture: an atypical presentation in a previously healthy patient.

UNLABELLED: Atraumatic splenic rupture represents a life-threatening abdominal event that requires immediate diagnosis and prompt surgical treatment to ensure the survival of the patient. Atraumatic rupture is relatively uncommon and can occur either in pathological spleens or, more rarely, in normal ones. It has a high morbidity, frequently with few and non specific signs suggesting its presence, can be associated to other pathologies incidentally discovered by imaging. We present a case, successfully treated, of a 51-year-old man, previously healthy, that referred to our hospital for arterial hypertension and abdominal pain; the patient, for an idiopathic splenic rupture with haemoperitoneum, underwent an open splenectomy whose histology examination showed a normal spleen. KEY WORDS: Atraumatic splenic rupture, Normal spleen, Spontaneos haemoperitoneum - Full text is available at: www.annaliitalianidichirurgia.it.