Peritoneal encapsulation in a patient with incomplete situs inversus

Peritoneal encapsulation [PE] is an extremely rare congenital condition in which there is abnormal return of the midgut loop to the abdominal cavity in the early stages of development. It may be present in patients with congenital anomalies like incomplete situs inversus. Pre-operative diagnosis is possible with abdominal CT. A 71-year-old man with incomplete situs inversus was admitted to emergency department with symptoms and signs of peritonitis. Computed tomography [CT] of the abdomen showed characteristic features of the PE syndrome. He had exploratory laparotomy performed and arterial occlusion caused ileocaecal ischaemia and PE was observed. Capsule of PE and ileocaecal excision was done. Postoperative recovery was uneventful

gallstone impacting to stomach wall imitating a gastric tumour

Authors describe a case of 78 years old female who presented with the right upper abdominal pain. Ultrasonography showed a gallstone. The patient underwent laparascopic cholecystectomy. The laparoscopic procedure was converted to laparotomy because the adhesions between gallblader and stomach could not be dissected on the correct plane. A gallstone impacted to the stomach antrum wall was observed during dissection. When dense adhesions are noted between the gallbladder and stomach during a routine laparascopic cholecystectomy, one should consider an impacted gallstone on the gastric wall via a cholecystogastric connection

Preoperative progressive pneumoperitoneum for giant inguinal hernias

Reduction of giant hernia contents into the abdominal cavity may cause intraoperative and postoperative problems such as abdominal compartment syndrome. Preoperative progressive pneumoperitoneum expands the abdominal cavity, increases the patient's tolerability to operation, and can diminish intraoperative and postoperative complications. Preoperative progressive pneumoperitoneum is recommended for giant ventral hernias, but rarely for giant inguinal hernias. We present two giant inguinal hernia patients who were prepared for hernia repair with preoperative progressive pneumoperitoneum and then treated successfully by graft hernioplasty. We observed that abdominal expansion correlated with the inflated volume and pressure during the first four days of pneumperitoneum. Although insufflated gas volume can be different among patients, we observed that the duration of insufflation may be the same for similar patients

Screening of gastric cancer in liver transplantation patients: a case report and review of literature

Liver and other solid organ transplant recipients are at an increased risk of developing several malignancies because of the immuno-suppressive treatment. Generally, patients who had a liver transplant have upper gastrointestinal tract complaints, which makes identification of gastric carcinoma symptoms in those patients difficult. A 58 years old liver transplant male patient presented to the hospital for his routine checkup and dyspeptic complaints. He had received a liver from a cadaver 18 months ago and his postoperative period had been uneventful. An esophagogastroduodenoscopy [EGD] revealed gastric cancer. A subtotal gastric resection with a D2 lymph node dissection was carried out. There was no recurrence during three years follow up. In order to make a timely identification of the occurrence of common malignancies such as gastric cancer, liver transplant recipients must be followed closely