Torsion of an Accessory Spleen; Diagnosed Preoperatively and Excised Laparoscopically

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.

Torsion of an Accessory Spleen; Diagnosed Preoperatively and Excised Laparoscopically

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.

Laparoscopic excision of uterine horn in case of unicornuate uterus firmly attached with non-communicating rudimentary horn / 대한산부인과내시경학회지

Unicornuate uterus is a very rare uterine anomaly caused by developmetal failure of Mullerian duct. This anomay is associated with various degrees of rudimentary horn, which is connected with fibrous band or firmly attached to unicornuate uterus. Different method of operation may be applied according to type of anatomical connection. The unicornuate uterus is commonly associated with severe dysmenorrhea, chronic pelvic pain, and pelvic mass. A case of noncommunicating rudimentary horn firmly attached to unicornuate uterus with severe dysmenorrhea was treated with laparoscopic excison of uterine horn and is presented with brief review of literature.

Laparoscopic Excision of an Intraabdominal Cystic Lymphangioma: a Case Report

Intraabdominal cystic lymphangioma is an uncommon lesion. It is usually found incidentally in patients presenting with an acute abdomen. Laparoscopic excision of intraabdominal cystic lymphangioma is an easy and safe procedure in children. We report one case of cystic lymphangioma in a 6-year-old female. The lesion was located on the left side of the transverse mesocolon. Laparocopic excision of the cyst was performed without complications.

Anesthetic Management during Laparoscopic Excision of an Urachal Cyst in a Pediatric Patient: A case report / 대한마취과학회지

A 14-month-old female patient was admitted for the laparoscopic excision of a complicated urachal cyst. General anesthesia was induced with thiopental and rocuronium and maintained with sevoflurane and the intermittent administration of vecuronium. During the insufflation of CO2 her intra-abdominal pressure was maintained below 12 cmH2O to avoid excessive hypercarbia. Thirty minutes after CO2 insufflation initiation, end tidal CO2 increased to 74 mmHg at a peak inspiratory airway pressure of 24 cmH2O. Laparoscopic excision of the urachal cyst was performed within 2 hours without a further change in end tidal CO2, blood pressure, heart rate, or O2 saturation. Before extubation, O2 saturation by pulse oxymetry was 99% and end tidal CO2 was 45-50 mmHg. The patient was discharged without any problem 5 days after the operation. We report on this clinical experience and include a brief review of the literature.

Laparoscopic Meckel's Diverticulectomy in Children

Meckel's diverticulum is one of the common causes of gastrointestinal bleeding in the pediatric patient requiring laparotomy. Two children with Meckel's diverticulum have been successfully treated by laparoscopic excision. Both patients recovered without incident and were discharged at 3 and 5 days after surgery. The authors believe that laparoscopic diverticulectomy is a safe, effective, and minimal invasive treatment of Meckel's diverticulum in children.