When a gastrostomy tube goes missing, acute bowel obstruction due to a migrated Foley catheter.

A gastrostomy is a common procedure for patients with swallowing problems or inability to maintain regular oral nutrition. These gastrostomy tubes need special attention, as complications can occur if the tubes are left unattended. In rare scenarios, these tubes can migrate and cause severe life-threatening difficulties such as bowel obstruction and pancreatitis. We present the case of a 76-year-old quadriplegic woman who had a gastrostomy tube. Suddenly, the tube was missing, and after urgent medical care, the gastrostomy tube was found within her bowel. After successful surgery, she recovered from this incident.

Gallbladder agenesis discovered during surgery, a sum of inadequate decisions.

Background: Gallbladder agenesis is an extremely rare congenital condition in which most patients will remain asymptomatic; nonetheless, a small subset of patients will mimic biliary, urinary, or gastrointestinal disorders. As a result, if these patients are unaware of their condition, an ultrasound may be needed when they present with right upper abdominal pain, which can be misleading or inconclusive, putting the surgeon and the medical team in a diagnostic and intraoperative dilemma. Case presentation: We present the case of a 36-year-old woman with a history of ventricular septal defect and cleft palate. She presented with abdominal pain to the emergency department. After an ultrasound, cholecystitis was misdiagnosed, and, unfortunately, the medical team did not realize this mistake. As a result, surgery was decided. After additional tests, gallbladder agenesis was diagnosed, and the patient fully recovered. Clinical discussion: Congenital absence of the gallbladder can often pose a dilemma to surgeons when it is diagnosed during surgery. Preoperative diagnosis is highly challenging as it can mimic other pathologies; therefore, the medical team needs to keep this pathology on their list of differential diagnoses to avoid dangerous procedures. Conclusions: Congenital absence of the gallbladder can often pose a dilemma to surgeons when it is diagnosed during laparoscopic cholecystectomy. Since preoperative diagnosis is challenging, communication between radiologists and surgeons is critical in order to provide proper care for any patient.

Fibromiomatosis uterina gigante: reporte de un caso / Giant uterine fibromyomatosis: case report

Comunicar el caso clínico de una paciente joven, con diagnóstico de fibromiomatosis uterina gigante, quien fue resuelta quirúrgicamente en forma satisfactoria. Se describe el caso, la técnica quirúrgica empleada y los hallazgos transoperatorios observados. Hospital Universitario “Dr. Luis Razetti”. Barcelona, Estado Anzoátegui. Se realizó histerectomía abdominal total, salpingectomía bilateral y ooforectomía derecha. El peso de la pieza quirúrgica fue de 13 kg. Durante el acto operatorio, se diagnosticó una lesión incidental de la vejiga, la cual fue reparada exitosamente. La evolución posoperatoria fue satisfactoria y la paciente manifestó un alto grado de satisfacción con el resultado quirúrgico. La fibromiomatosis uterina gigante es una entidad patológica benigna de muy escasa incidencia. Su resolución representa un reto para el equipo quirúrgico debido al gran volumen de la pieza quirúrgica y a las variaciones en la distribución de los órganos intraabdominales, originadas por el recimiento uterino.