Complications associated with two laparoscopic procedures used in the management of rectal endometriosis.

BACKGROUND: To evaluate intra- and postoperative complications associated with laparoscopic management of rectal endometriosis by either colorectal segmental resection or nodule excision. METHODS: During 39 consecutive months, 46 women underwent laparoscopic management of rectal endometriosis and were included in a retrospective comparative study. The distinguishing feature of the study is that the choice of the surgical procedure is not related to the characteristics of the nodule. RESULTS: Colorectal segmental resection with colorectal anastomosis was carried out in 15 patients (37%), while macroscopically complete rectal nodule excision was performed in 31 women (63%). No intraoperative complications were recorded. In the colorectal resection group, 3 women (18%) had a bladder atony (spontaneously regressive in 2 women), 4 women (24%) experienced chronic constipation, one had an anastomosis leakage (6%), while 2 women (13%) had acute compartment syndrome with peripheral sensory disturbance. In the nodule excision group, 1 woman (4%) developed transitory right obturator nerve motor palsy. Based on both postoperative pain and improvement in quality of life, all 29 women in the excision group (100%) and 14 women in the colorectal resection group (82%) would recommend the surgical procedure to a friend suffering from the same disease. CONCLUSION: Our study suggests that carrying out colorectal segmental resection in rectal endometriosis is associated with unfavourable postoperative outcomes, such as bladder and rectal dysfunction. These outcomes are less likely to occur when rectal nodules are managed by excision. Information about complications related to both surgical procedures should be provided to patients managed for rectal endometriosis and should be taken into account when a decision is being made about the most appropriate treatment of rectal endometriosis in each case.

[Cystic lymphangioma of the adrenal gland, from radiologic diagnosis to laparoscopic treatment. A case report]. / Lymphangiome kystique de la surrénale, du diagnostic radiologique au traitement laparoscopique. A propos d'une observation.

BACKGROUND: Cystic lymphangioma of the adrenal gland is a rare tumor, which is often asymptomatic. Pre-operative diagnosis is difficult. Echography and CT scan are essential exploratory techniques. Surgical exploration is usually indicated due to uncertain diagnosis. AIM: Report of a new case CASE: We report a new case of cystic lymphangioma of the left adrenal gland, in a 30 year-old female, treated with a laparoscopic excision and confirmed by anatomopathologic features.

A misleading renal tumour.

Hydatid cyst of the kidney is uncommon and still constitutes about 3% of cases of hydatid disease. The diagnosis can be made by ultrasonbography, Ct-scan and in some difficult cases by MRI. We report a case of a renal hydatid cyst in a 47-year-old man mimicking at imaging, even at MRI, a hypovascular renal tumour.

Percutaneous drainage of suppurative pylephlebitis complicating acute pancreatitis.

Suppurative pylephlebitis is a rare condition with a significant mortality rate, ranging from 50% to 80%. We report a case of suppurative pylephlebitis complicating acute pancreatitis treated by percutaneous drainage in a 40-year-old woman. The patient had an uneventful recovery.

Fibrolipoma of the median nerve.

Neural fibrolipoma or fibrolipomatous hamartoma is an uncommon benign tumor that usually arises in the median nerve. Fibrofatty tissue proliferates around the nerve and infiltrates the epineurium and perineurium. We report a case of fibrolipomatous hamartoma of the left median nerve in an 18-year-old woman. Our objective was to describe the pathognomonic magnetic resonance imaging features, whose presence obviates the need for a diagnostic biopsy.