A Rare Presentation of Small Bowel Angiomyolipoma: A Case Report.

Angiomyolipoma (AML) of the small bowel is a rare entity. It usually presents with intestinal obstruction, gastrointestinal hemorrhage, or intussusception. However, sometimes it may have an unusual presentation, posing intraoperative challenges. Here we report an unusual presentation of this rare disease. A 32-year-old male presented to the emergency department following an abandoned irreducible right inguinal hernia repair at a peripheral hospital. The patient had a transected segment of small bowel extruding from the incision site, sutured to the skin margin. On assessment, a 6x2 cm mass was discovered arising from the transected segment of the extruding bowel. After a formal exploratory laparotomy, a segment of small bowel, including the mass and transected bowel, was resected and brought out as a double-barrel ileostomy in the right iliac fossa. The right inguinal hernia was repaired with Bassini's herniorrhaphy. Histopathological examination confirmed the mass lesion as an AML. This case underlines the necessity of a comprehensive preoperative assessment and knowledge of uncommon intra-abdominal pathology. Proper diagnosis and surgical planning are required to prevent intraoperative complications and enable total excision, thereby minimizing the chance of recurrence.