Littoral-cell angioma of the Spleen

Littoral- cell angioma [LCA] is a rare vascular tumor of the spleen. It was thought to be a benign, incidental lesion. However, many recent reports have described it to be a malignant lesion with congenital and immunologic associations. We report a case of LCA of the spleen, which has been infrequently communicated in the literature. A 41-year-old female patient was admitted to our hospital with a three-week history of weakness, weight loss, anorexia, and intermittent upper abdominal pain which improved slightly with antacid medication.Imaging studies, including computed tomography [CT] and magnetic resonance imaging [MRI], showed multiple lesions in the spleen. Laparoscopic splenectomy was performed

rare case of perforated Meckel's diverticulum presenting as a gatrointestinal stromal tumor

Meckel's diverticulum is located on the antimesentric border of the ileum, approximately 45 to 60 cm proximal to the ileocecal valve, and results from incomplete closure of the omphalomesentric or viteline duct. Common complications presenting in adults include bleeding, obstruction, diverticulitis, and perforation. Tumors within Meckel's diverticulum are a rare, but recognized complication. A 62year-old woman presented with peri-umbilical pain that had localized to the right iliac fossa. On examination, she was tender in the right iliac fossa, with localized peritonism. At surgery, a perforated Meckel's diverticulum was found that was associated with free intra-abdominal fluid and hemorrhage. A 25 mm nodule was found at the apex of Meckel's diverticulum.We resected 100 mm of the small bowel and a pri-mary anastamosis was performed.Histopathological examination of the resected lesion revealed a mesenchymal tumor categorized as a gastrointestinal stromal tumor [GISTs]. GISTs arising from Meckel's diverticulum are an extremely rare, but recognized complication. Surgery is considered the standard treatment for non-metastatic GISTs with enbloc resection and clear margins

Intraabdominal abscess following inguinal hernioplasty

The intra-abdominal omental abscess following hernioplasty is a rare late post-operative complication. We report on a patient with intraabdominal abscess that developed after an inguinal hernia repair that utilized synthetic mesh. Infection resolved following thorough debridement, mesh removal, percutaneous drainage for abdominal abscesses and prolonged antimicrobial therapy

Intestinal obstruction due to anomalous congenital band

Intestinal obstruction caused by an anomalous congenital band is very rare in adults and children. ACBs [Anomalous congenital band] are bands that have no identifiable embryological or acquired basis. We report an unusual case of intestinal obstruction in a 23 year old male patient who was found to have an ACB forming a loop around the jejunum [Fig-1] and causing closed loop obstruction. This band was arising from the treitz ligamentum and looping around the jejunum, ending at the root of mesentery. This band was in addition, causing compression of blood supply to the proximal jejunum

Laparoscopic cholecystectomy in a patient with situs inversus: Advantage of 30 scope

Laparoscopic cholecystectomy is one of the commonest surgical procedures carried out in the world today. Symptomatic gallstones needs surgery also patients with situs inversus. We discuss our case and problems encountered during surgery and how to solve them. A 50-year-old male presented with recurrent epigastric and left hypochondriac pain for the last year. A diagnosis of gallstones in a patient with situs inversus totalis was made following clinical examination and radiological investigation. Laparoscopic cholecystectomy was subsequently performed and the patient made an uneventful recovery. Situs inversus presenting with symptomatic gallstones is very rare. Laparoscopic cholecystectomy and other abdominal surgical operations are more difficult in patients with situs inversus hence they are rarely practiced

case of psoas abscess due to brucellosis

Skeletal system involvement is relatively a common complication of human brucellosis, however, muscular involvement and psoas abscess are less frequent. Psoas abscess is a rare clinical situation which if not considered the diagnosis is very difficult. Ultrasonography and computed tomography of abdomen are used for the diagnosis. Combination of antibiotic treatment and drainage are recommended in the management of psoas abscess. We report a case of 45 years old patient with severe hip pain with an abscess in the psoas muscle which was diagnosed with CT Scan. The patient was successfully treated with triple antibiotic regimen and percutaneous abscess drainage

use of fibrin glue in surgical treatment of pilonidal sinus disease: a prospective study in the limberg flap procedure

Different surgical techniques for pilonidal disease have been described in the literature. Limberg flap has low morbidity and recurrence rates. Fibrin sealant, a two-component tissue adhesive composed of fibrinogen and thrombin, has been used in a number of surgical procedures to achieve hemostasis and to seal tissues. The purpose of this study was to investigate the effect of fibrin sealant on the Limberg flap procedure. 132 male patients with pilonidal sinus who underwent Limberg flap operation were evaluated prospectively. The patients were assigned randomly into two groups [group 1; with suction drain, group 2; fibrin glue]. Seroma was encountered in 5 of 132 patients [3.78%]; Flap oedema occurred 4[6.06%] patients in group 1. Wound infection occurred in one patient [1.5%] in group 1. Most patients in group 2 were mobilized on the first postoperative day, and the median time to first mobilization was earlier in group 2 than in group 1 [1 [1-1] versus 2 [1-2] days respectively; P<0001]. The median duration of incapacity for work was 17 [15-20] days in group 1 and 8 [6-12] days in group 2 [P< 0.001]. Total wound dehiscence and flap necrosis did not occur in any patient. There has been no recurrence in any of the patients during the follow-up period. The mean time for complete healing of wound after rhomboid excision and Limberg flap plus fibrin sealant was 8.13 +/- 7.88 days [range 6-28 days]. This was markedly increased in group 1 patients [mean 22.08 +/- 8.59 days, and range 15-60][p < 0.001]. We recommend the use of fibrin sealant with Limberg flap technique. Our results suggest that drains may be avoided with fibrin sealant