Diagnostic laparoscopy and resection of a rare case of large mesenteric liposarcoma

Liposarcoma arising from the mesentery of the bowel is a rare lesion. Some of the most common presenting symptoms of primary mesenteric liposarcoma is increasing abdominal girth, weight loss, abdominal pain, abdominal discomfort with meals and the presence of a freely movable abdominal mass or masses. Our patient presented with a large intra-abdominal mass. Diagnostic laparoscopy revealed tumor confined to the mesentery of the ileum. Laparoscopy was attempted, though conversion was necessary to achieve negative margins. Laparotomy was required to resect the tumour with wide margins. Myxoid and well-differentiated types of liposarcoma are by far the most common histological type. Tumor size greater than 20cm predict significantly poorer prognosis. The treatment of choice for primary mesenteric liposarcoma is surgical resection with clear margins. Radiotherapy or systemic chemotherapy has no benefit in increasing long-term survival. Laparoscopy is of limited value

Laparoscopic management of perforation of a manginal ulcer following anterior gastrojejunostomy

Marginal ulcer is a well-known complication following gastrojejunostomy especially if vagotomy is not done or is incomplete and in anterior gastrojejunostomies. We report a case of marginal ulcer perforation in a 45-year old male who presented with peritonitis and a history of undergoing surgery for peptic ulcer disease 20 years back. Diagnostic laparoscopy revealed extensive soiling and a 1.5cm perforation on the efferent Loop of an anterior gastrojejunostomy Laparoscopic closure was done. There are only few reports of similar conditions published in the literature. With experience, it is feasible to use laparoscopy for the management of uncommon acute conditions like this one