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Case Reports
. 2025 Sep 11;17(9):e92041.
doi: 10.7759/cureus.92041. eCollection 2025 Sep.

A Rare Presentation of Small Bowel Angiomyolipoma: A Case Report

Aneesh Kumar  1 , Ujjwal Sikhar  1 , Mumtaz A Ansari  1 , Arvind Pratap  1 , Vivek Srivastava  1
Affiliations
Case Reports

A Rare Presentation of Small Bowel Angiomyolipoma: A Case Report

Aneesh Kumar et al. Cureus. .

Abstract

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.

Keywords: angiomyolipoma; bowel obstruction; complicated inguinal hernia; herniorrhaphy; small bowel tumor.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Transected bowel loop sutured to the skin (red arrow) and the attached mass lesion (green arrow).
Figure 2
Figure 2. Completely transected ileal loop (blue arrow) with the attached mass lesion on the proximal end (white arrow). The yellow arrow indicates the incision site in the right inguinal region.
Figure 3
Figure 3. Cut section of the mass lesion, revealing adipose tissue (purple arrow) and blood vessels (yellow arrow) within it.
Figure 4
Figure 4. Incision lines for the midline exploratory laparotomy and right inguinal hernia repair, along with the double-barrel ileostomy in the right iliac fossa.
Figure 5
Figure 5. Histopathological image showing features of AML. The section demonstrates dilated and congested blood vessels (black arrow), mature adipocytes (yellow arrow), and bundles of smooth muscle cells (red arrow).
AML, angiomyolipoma
See this image and copyright information in PMC

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