ABSTRACT
A 52 year-old man, treated by neuroleptic drugs, presented with a cow horn injury in the right Scarpa's triangle. The surgical management found no injury of femoral vessels. Surgical hemostasis of superficial vessels was performed. An ileal strangulation appeared three days later. At laparotomy, we found an internal parietal wound. Here we explain the mechanism of this strangulation.
Subject(s)
Ileal Diseases/etiology , Intestinal Obstruction/etiology , Thigh/injuries , Wounds, Penetrating/complications , Acute Disease , Animals , Cattle , Humans , Male , Middle AgedABSTRACT
A 37 year old-woman complained about persistant pain of right abdominal quadrant. We discovered many hepatic lesions. Histology revealed benign processus. Evolution was marked by peritoneal carcinomatosis. After reexamination of histology we discovered hepatic haemangioendothelioma. The patient died 18 month after diagnosis although chemotherapy.
Subject(s)
Hemangioendothelioma , Liver Neoplasms , Adult , Fatal Outcome , Female , Hemangioendothelioma/diagnosis , Humans , Liver Neoplasms/diagnosisABSTRACT
The cecum is the second most common site of colonic volvulus after the sigmoid. The mechanism is torsion or hyperflexion of the enlarged, poorly-fixed, and hypermobile cecum. It presents clinically as an acute bowel obstruction with strangulation. Diagnosis can be made by plain abdominal X-ray in more than half the cases on the basis of cecal distention (with a classical "teardrop" or "comma" appearance), proximal small bowel distention with air-fluid levels, and a gasless distal colon. Barium enema shows lack of filling of the cecum, often with a "beaked" termination of the column of contrast. CT images are pathognomonic when they reveal a cecal "vortex". After surgical reduction of the torsion, ileo-cecal resection is usually the best therapeutic alternative. Cecopexy may be aDDrouriate in older and debilitated Datients if there is no concomitant cecal necrosis.
Subject(s)
Cecal Diseases/diagnostic imaging , Cecal Diseases/surgery , Intestinal Volvulus/diagnostic imaging , Intestinal Volvulus/surgery , Barium , Diagnosis, Differential , Digestive System Surgical Procedures/methods , Enema , Humans , Prognosis , Tomography, X-Ray ComputedABSTRACT
A 47-year old man complained about persistant pain and cholestasis 12-years after a cholescystectomy. In his family, all his brothers and sisters had cholecystectomy. Genetic explorations revealed a MDR3 gene mutation. All symptoms disappeared with a treatment by ursodesoxycholic acid. MDR3 gene mutation is to be researched in all cases of familial cholestasis.
Subject(s)
ATP Binding Cassette Transporter, Subfamily B/genetics , ATP-Binding Cassette Transporters/genetics , Cholestasis, Intrahepatic/genetics , Cholagogues and Choleretics/therapeutic use , Cholecystectomy , Cholestasis, Intrahepatic/pathology , DNA Mutational Analysis , Humans , Male , Middle Aged , Pain/etiology , Pedigree , Ursodeoxycholic Acid/therapeutic useABSTRACT
We report a case of postoperative inferior mesenteric arteriovenous fistula. Arteriovenous fistula represents a rare disease. Symptoms are due to portal hypertension and distal ischemy. Treatment of these fistulas is embolization. Surgery is possible by ligature or excision of the fistula because vascularisation is obtained by Riolan arcade and hypogastric artery.
Subject(s)
Arteriovenous Fistula/etiology , Arteriovenous Fistula/therapy , Embolization, Therapeutic , Mesenteric Arteries/pathology , Mesenteric Veins/pathology , Postoperative Complications , Arteriovenous Fistula/complications , Humans , Hypertension, Portal/etiologyABSTRACT
We report the case of a patient who underwent splenectomy for spontaneous rupture of the spleen due to splenic metastasis. Pathologic examination revealed diffuse infiltration by carcinoma. Chest X-ray revealed a right lung superior lobe tumor, related to poorly differentiated carcinoma. Total splenectomy is a good option for diagnosis and treatment of splenic metastases.
Subject(s)
Lung Neoplasms/pathology , Splenic Neoplasms/complications , Splenic Neoplasms/secondary , Splenic Rupture/etiology , Aged , Humans , Male , Rupture, SpontaneousABSTRACT
An 80-year-old woman with sigmoïd diverticula was treated by corticosteroid for Horton disease. She presented abdominal pain, and abdominal mass in left iliac fossa. Radiological examinations revealed a colo-jejunal fistula. At laparotomy it was a giant diverticulum of colon sigmoid with fistula in the jejunum. The pathogeny of giant diverticulum and the role of corticosteroid are discussed.
Subject(s)
Diverticulosis, Colonic/complications , Intestinal Fistula/etiology , Jejunal Diseases/etiology , Sigmoid Diseases/complications , Aged , Aged, 80 and over , Diverticulosis, Colonic/pathology , Female , Humans , Sigmoid Diseases/pathologyABSTRACT
We herein report five cases of heterotopic pancreas localized on common bile duct, gastric antrum, duodenum (two cases including one with cystic dystrophy), and jejunum. The choledocal localization was revealed by jaundice. The duodenal localization with cystic, diagnosed by endoscopic ultrasound, was revealed by onsets of acute pancreatitis. All localizations were treated by resection: antrectomy, bowel resection, and pancreaticoduodenectomy. Postoperative course was uneventful. Review of the literature shows that, even in uncomplicated cases, resection is usually performed.
Subject(s)
Choristoma , Gastrointestinal Diseases , Pancreas , Adult , Choristoma/diagnosis , Choristoma/surgery , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/surgery , Humans , Male , Middle AgedABSTRACT
We herein report a case of axillary localization of supernumerary breast. It is a matter of axillary bilateral masses mistaken as lipoma at clinical examination and ultrasonography. We here explain this confusion between lipoma and supernumerary breast. The aim of this work is to specify clinical characters of an axillary mass that must lead to suspect a supernumerary breast.
Subject(s)
Breast Neoplasms/diagnosis , Breast/abnormalities , Diagnostic Errors , Lipoma/diagnosis , Adult , Axilla , Congenital Abnormalities/diagnosis , Diagnosis, Differential , Female , HumansABSTRACT
A patient underwent at his birth, an ureterosigmoidostomy for exstrophic bladder. Fifty-six years later, she presented a carcinoma on the right ureterosigmoidostomy associated with chronic urinary infection. She underwent a right ureteronephrectomy and sigmoidectomy. Chronic alterations of the colic mucin by urines lead to carcinoma.
Subject(s)
Bladder Exstrophy/surgery , Colonic Neoplasms/surgery , Kidney Diseases/surgery , Postoperative Complications/surgery , Colon, Sigmoid/surgery , Female , Follow-Up Studies , Humans , Infant, Newborn , Middle Aged , Nephrectomy , Time Factors , Ureter/surgeryABSTRACT
BACKGROUND: Colonic necrosis after acute pancreatitis is rare. When it does occur, it is commonly due to ischaemia or inflammation and may necessitate early colonic resection. CASE OUTLINE: A 72-year-old man developed colonic necrosis 6 weeks after severe acute pancreatitis. CT scan revealed a bulky mass near the left colon. Barium enema and colonoscopy revealed stenosis of the left colonic flexure, and this segment of bowel was successfully resected. DISCUSSION: Severe acute pancreatitis must be recognised as a cause of colonic ischaemia and necrosis. The possible pathogenic mechanisms include severe local inflammation and an ischaemic process. This complication is associated with a very poor prognosis despite surgical intervention, but a timely resection may prevent further problems.
