ABSTRACT
Eleven patients, 8 women and 3 men, mean age 69.9 years (range 54-81) were operated with a gallstone ileus during a seven years period. Echography and barium study of small bowel were made in 8 and 2 patients, and gave a diagnostic rate of 37% and 100%, respectively. A preoperative diagnosis was made in 72.2% of cases, simple enterolithotomy was made in 8 cases and in three cases a definitive treatment of biliary pathology was added. There was no mortality and a major complication was observed in 1 patient without biliary surgery (evisceration and recurrence of biliary ileus); no major complications were seen in patients with primary biliary surgery. With a careful, selection, surgery can be made without mortality nor morbidity.
Subject(s)
Cholelithiasis/surgery , Cholestasis/surgery , Aged , Aged, 80 and over , Bile Duct Diseases/complications , Bile Duct Diseases/surgery , Cholelithiasis/complications , Cholestasis/etiology , Female , Humans , Intestines/surgery , Male , Middle Aged , Retrospective Studies , Surgical Procedures, Operative/methodsABSTRACT
A case is presented of a 10-year-old female twin with a cystic liver mass that debuted as a painless epigastric mass. The lesion was excised by hepatectomy of segments II and III, confirming in the review of the cavity the presence of a common mesentery with cecocolonic malposition. The postoperative course was normal and clinical and echographic study of her twin sister disclosed no anomalies. The anatomopathologic study of the lesion revealed a tumor of difficult filiation that presented features of mesenchymal hamartoma together with others of biliary cystadenoma. The amount and nature of the stromal component, together with the patient's age at appearance, made us classify the case as mesenchymal hamartoma. The morphologic findings observed seem to support the histopathologetic theory of a congenital origin.
