ABSTRACT
We present the case of a female patient in her 40s who underwent a splenic artery aneurysm (SAA) repair following a previous laparoscopic sleeve gastrectomy (SG). We aim to discuss the management approach to SAAs and considerations in the setting of previous bariatric surgery.The patient consented to this case report. We include preoperative and postoperative radiological images and intraoperative images.While pseudoaneurysms following bariatric surgery have been reported, we present a case of a likely true SAA following SG. Our experience may assist others who come across similar cases in the future.
Subject(s)
Aneurysm , Gastrointestinal Diseases , Laparoscopy , Obesity, Morbid , Humans , Female , Obesity, Morbid/complications , Obesity, Morbid/surgery , Splenic Artery/diagnostic imaging , Splenic Artery/surgery , Laparoscopy/methods , Gastrectomy/methods , Aneurysm/diagnostic imaging , Aneurysm/etiology , Aneurysm/surgeryABSTRACT
Synchronous malignancies of the bile duct and the gallbladder are rare. These cases are often associated with pancreaticobiliary maljunction which is characterized by a long common shared pancreatobiliary channel leading to the Sphincter of Oddi. This predisposes the biliary epithelium to pancreatic enzyme reflux and makes the development of neoplasia more likely. We describe the case of a 64-year-old Caucasian female who presented with new jaundice and severe cholecystitis secondary to an impacted gallstone which was seen on ultrasound. Magnetic resonance cholangiopancreatography was organized with suspicion of a possible Mirizzi syndrome. This revealed a mid-distal bile duct cancer in addition to cholecystitis from an impacted gallstone. She was treated with intravenous antibiotics for her cholecystitis and underwent an urgent endoscopic retrograde cholangiopancreatography procedure for biliary decompression and stenting for her obstructive jaundice. The patient proceeded to pancreaticoduodenectomy with final histopathology revealing a synchronous primary gallbladder malignancy in addition to the known bile duct cancer.
Subject(s)
Broad Ligament , Hernia, Abdominal , Hernia, Inguinal , Round Ligament of Uterus , Broad Ligament/surgery , Female , Humans , Internal HerniaSubject(s)
Gallstones , Gastric Outlet Obstruction , Ileus , Intestinal Obstruction , Gallstones/complications , Gallstones/surgery , Humans , Ileus/etiology , Ileus/surgerySubject(s)
Cholecystectomy, Laparoscopic/adverse effects , Mesenteric Veins/pathology , Portal Vein/pathology , Thrombosis/etiology , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Diarrhea/diagnosis , Diarrhea/etiology , Hemorrhage/diagnosis , Humans , Laparotomy/methods , Male , Mesenteric Veins/diagnostic imaging , Middle Aged , Portal Vein/diagnostic imaging , Rectum/blood supply , Rectum/pathology , Thrombosis/diagnostic imaging , Tomography, X-Ray Computed/methods , Ultrasonography, Doppler, Duplex/methodsSubject(s)
Fused Kidney/complications , Hernia, Inguinal/diagnosis , Scrotum , Ureteral Diseases/diagnosis , Aged , Diagnosis, Differential , Fused Kidney/diagnosis , Hernia, Inguinal/complications , Hernia, Inguinal/surgery , Herniorrhaphy/methods , Humans , Laparoscopy , Male , Tomography, X-Ray Computed , Ureteral Diseases/complications , Ureteral Diseases/surgery , UrographySubject(s)
Esophageal Neoplasms/pathology , Esophageal Squamous Cell Carcinoma/pathology , Esophageal Neoplasms/etiology , Esophageal Neoplasms/therapy , Esophageal Squamous Cell Carcinoma/etiology , Esophageal Squamous Cell Carcinoma/therapy , Humans , Precancerous Conditions/etiology , Precancerous Conditions/pathologyABSTRACT
A 77-year-old man presented with watery, bloody diarrhoea, symptomatic anaemia and signs of sepsis. He was well known to our unit with a history of extensive low-grade urothelial carcinoma involving a solitary kidney. CT performed on admission demonstrated a new finding of renocolic fistula. Due to his multiple medical and surgical comorbidities conservative management was elected. He passed away after 1 year of follow-up.
