Urachal cyst in adulthood: case report with detailed laparoscopic management and review of literature

An urachal cyst anomaly occurs in approximately 1/5,000 births. Its treatment is surgical excision. We present a case report of 16-year-old female with presenting complaints of lower abdominal pain with burning micturition and increased urinary frequency. Computed tomography revealed a 40×38 mm low-density cyst image located in midline cranial to the bladder apex, suggesting the diagnosis of urachal cyst. Traditional open surgery was used for its excision, but now minimally invasive approaches have been used more frequently to minimize the morbidity. We did a trans-abdominal preperitoneal approach, which aided in both the purpose of diagnostic laparoscopy and also utilize the advantage of preperitoneal surgery.

Laparoscopic management of appendicular lump

The surgical management of an appendicular lump remains controversial. With the revolution and advancement of laparoscopic instrumentation and technical learning curve, it is possible to remove an inflamed appendix in presence of lump. This retrospective study was performed between August 2018 and August 2019 in AIIMS Raipur, 86 patients were treated for appendicitis laparoscopically, in these 14 patients had appendicular lump at the time of admission. 12 patients (total 14; 2 patients were excluded) underwent laparoscopic intervention for appendicular lump. Average operative time were 90 minutes. Average post-operative hospital stay were 5 days. Post-operative complications were seen in 2 patients (surgical site infection). In histopathology report, appendicular inflammation suggestive of appendicitis were present in all operated cases. We conclude, early laparoscopic appendectomy confirms the diagnosis. It is safe and feasible in patients with appendicular lump. It reduces the treatment cost, early recovery and satisfactory overall outcome.

Giant Ovarian Cyst: A Case Report.

Cystic abdominal tumors are extremely common. Now a day they are diagnosed more frequently and much earlier due to availability of better imaging modalities. Presentation of large ovarian cysts has become rare as most of them are diagnosed and treated early. Still we get reports of patients with large/giant benign abdominal cysts and many of them are serous cyst adenoma of ovary. Mucinous cyst adenomas (MCAs) of the ovary are known for their potential to grow to massive proportions and are often incidentally diagnosed. They are typically benign tumors accounting for 15% of ovarian neoplasm's and up to 80% of all mucinous tumors. Sometimes, it becomes very difficult to identify the source of these cysts and are misdiagnosed as mesenteric cyst. Final diagnosis is only possible at laparotomy. Here we report a case of Giant ovarian cysts in an octogenarian female, weighing 27 kgs.

Laparoscopic management of early primary peritoneal pregnancy: a case report / 대한생식의학회지

Peritoneal pregnancy is an implantation in the peritoneal cavity exclusive of tubal, ovarian, or intra-ligamentary implantations. This is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and secondary type was most common. Risk factors for peritoneal pregnancy are previous history of extrauterine pregnancy or tubal surgery pelvic post-inflammatory status or presence of an intra-uterine device. As it is a life-threatening condition, expectant management carries a risk of sudden life-threatening intra-abdominal bleeding and a generally poor fetal prognosis. So, when it is recognized, immediate termination of pregnancy is usually recommended. Early diagnosis of peritoneal pregnancy is difficult, but is important by their life threatening progress course to patients. Recently, we experienced primary peritoneal pregnancy which meets both the original and modified criteria. In this paper, we reported the case of early diagnosed and successfully treated peritoneal pregnancy despite of their diagnosis was incidentally.

A case of severe hydronephrosis due to ureteral stricture from endometriosis / 대한산부인과학회지

Endometriosis is a relatively common disease, affecting 5-10% of women of reproductive age. But, endometriosis affecting the urinary tract is very rare entity. Involvement of urinary tract by endometriosis occurs in about 1% of women with pelvic endometriosis. Ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms at clinical presentation and difficult preoperative diagnosis. The involvement of the ureter is rarely intrinsic by implantation of endometrial tissue in the wall of the ureter, but rather due to external compression by adjacent endometriosis and its attendant inflammation and fibrosis. We have experienced a case of right severe hydroureteronephrosis due to ureteral stricture from endometriosis. Laparoscopic nephrectomy was done due to renal atrophy. At the same time, laparoscopic total hysterectomy with right salpingo-oophorectomy was performed because of the uterine adenomyosis and right ovarian endometrioma. So, we report that with a brief review of literatures.

Laparoscopic management of uterine anomaly associated with agenesis of unilateral kidney and pelvic endometriosis: two case reports / 대한산부인과학회지

Unicornuate uterus with a rudimentary horn hematometra and bicornuate uterus with unilateral hematometra is rare congenital anatomic anomalys of the female genital system. these patients present with dysmenorrhea, dyspareunia, pelvic mass, urinary tract anomalies and pelvic endometriosis. We have experienced a case of rudimentary uterine horn hematometra with agenesis of ipsilateral kidney and pelvic endometriosis in a 18 years old girl and a case of bicornuate uterus with unilateral hematometra associated with agenesis of ipsilateral kidney and pelvic endometriosis in a 14 years old girl. and we treated by laparoscopic management. So we report two cases with a brief review of literatures.