ABSTRACT
BACKGROUND: Hemochromatosis, North America's most prevalent genetic disorder, tends to present with an insidious onset and subtle, yet characteristic findings. Patients tend to present with both constitutional symptoms and end-organ effects. METHODS: Clinical criteria such as history, physical examination, imaging criteria with focused radiologic constellations, and laboratory findings were used for diagnosis. RESULTS: We report the case of a man who lacked classic systemic symptoms, but instead presented with isolated metacarpophalangeal joint disease and characteristic radiologic findings. The diagnosis was confirmed by serum iron studies and subsequent genetic work-up. CONCLUSIONS: A high index of clinical suspicion is required to diagnose early disease; better prognostic responses are expected with treatment of less severe disease. Hand surgeons should be aware of the characteristic findings for this rare presentation so proper treatment can be initiated early.
ABSTRACT
Spilled gallstones during laparoscopic cholecystectomy are associated with a number of complications such as infection, abscess, inflammation, adhesions, cutaneous sinuses, small bowel obstruction, incarcerated hernia, and generalized septicemia. We report a case of a patient with middle colic vessel erosion and thrombosis secondary to a retained gallstone following laparoscopic cholecystectomy 11 years ago. At operation, the patient was found to have a necrotic transverse colon with a large 2 cm gallstone compressing her middle colic vessels. An extended right hemicolectomy was performed with a primary anastomosis. The importance of stone retrieval during laparoscopic cholecystectomy is emphasized.
