ABSTRACT
Meckel's diverticulum is the commonest congenital abnormality of the gastrointestinal tract. Most cases are asymptomatic and only incidentally found. Its perforation by a foreign body is an extremely rare event. A 53-year-old female presented to Emergency Department with abdominal pain on the right iliac fossa and vomiting. CT scan was performed and showed an intestinal perforation by a foreign body. Diagnostic laparoscopy identified a perforation of a Meckel's diverticulum by a fish bone and a laparoscopic stapled diverticulectomy was performed. Meckel's diverticulum complications are more common in childhood, usually as bleeding. In adults, intestinal obstruction and inflammation are the usual manifestations. Although most swallowed foreign bodies are harmless, in a small number of cases perforation may occur. Preoperative diagnosis of complicated Meckel´s diverticulum is challenging and can often mimic other more common conditions. Laparoscopy is a valuable tool for the diagnosis and treatment of complicated Meckel's diverticulum.
ABSTRACT
Colon interposition in oesophageal replacement after oesophagectomy for benign strictures is associated with significant perioperative complications that carry high morbidity and mortality. Long-term sequelae such as further strictures and colonic redundancy are frequent. Adenocarcinoma in the colonic graft is rare. A 70-year-old female presented to our clinic with symptoms of dysphagia. When she was 51 years, she underwent left colonic oesophageal interposition for an oesophageal stricture caused by caustic ingestion. Studies revealed colonic adenocarcinoma in interposed colonic graft, with latero-cervical lymph nodes. She was proposed to neoadjuvant chemotherapy. Although long-term risk analysis is lacking, it's not unreasonable to propose endoscopic screening according to general colonic cancer guidelines in patients with colonic interposition in oesophageal replacement after oesophagectomy.
