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Epithelioid leiomyomas of the gastrointestinal tract are difficult to diagnose before surgery and their malignancy is not readily evaluated. The tumor is of smooth muscle origin, arising from the muscularis propria, and frequently develops in the gastrium, occasionally extending into the gastrocolic ligament or greater omentum. Malignancy is evaluated from the numbers of mitotic cells per 50 high power fields. However, even a tumor with few mitoses may metastatize. Thus, we propose that the malignancy of the tumor should be decided in terms of location, size, pattern of growth, invasion of the mucosa, cellularity, mitotic rate, and anaplasia. We reported a case of epithelioid leiomyoma that was pedunculated, with exogastric expansion. The literature is reviewed.

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A case of intestinal evisceration through the anus due to spontaneous rupture of the rectosigmoid is reported. The patient was a 76-year-old widow with habitual constipation. The episode of evisceration occurred during effort. Emergency laparotomy was carried out and a 6-cm tear was found in the anterior wall of the rectum. No fecal soilage was observed in the peritoneal cavity. The laceration was closed in two layers. A colostomy was not performed. The postoperative course was satisfactory. Increased abdominal pressure may have been the cause of the rupture. Anemia and hypoproteinemia were observed in the patient. These may have been contributing factors.

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