Pregnant woman with fatal complication after laparoscopic Roux-en-Y gastric bypass.

In Europe, an increasing number of women have bariatric surgery; therefore, obstetricians are likely to encounter these patients. We report a 22-year-old woman, who had previously undergone uncomplicated laparoscopic Roux-en-Y gastric bypass. She was admitted with severe abdominal pain at 35 weeks of gestation. A cesarean section with delivery of a healthy baby in combination with an exploratory laparotomy was performed. Internal herniation was suspected, but not identified during surgery. Three days later she died of a severely gangrenous small bowel secondary to internal herniation. This fatal case illustrates a potential complication and difficulties in the management of pregnant women who have undergone Roux-en-Y gastric bypass. In these women, observation and investigations based on a multidisciplinary approach are vital if abdominal pain develops, with involvement of intestinal surgeons experienced in bariatric surgery, as well as radiologists with specific knowledge of relevant imaging procedures.

[Granular cell tumor of the colon--Abrikossoff's tumor]. / Granularcelletumor i colon--Abrikossoffs tumor.

A 50-year-old woman had a right hemicoletomy due to a large sessile polyp in the ascending colon, inappropriate for polypectomy. Histopathologic examination of the specimen showed a tubulovillous adenoma with moderate dysplasia and an adjacent 1 x 1 cm submucosal tumor classified as a benign GCT due to the appearance in the light microscope and immunohistochemical analysis. To our knowledge, this is the first reported case of synchronic adenoma and GCT in the colon. To date there is no evidence of any association or disposing factors between GCT in the colon and colonic adenomas or malignancy.

[Implementation of laparoscopic resection of the sigmoid colon, initial results and experiences]. / Implementering af laparoskopisk sigmoideumresektion, initiale resultater og erfaringer.

INTRODUCTION: In recent years, the enthusiasm for laparoscopic surgery has been immense. In Denmark, laparoscopic surgery of the colon has been performed in only a few cases each year. In other countries, laparoscopic surgery foreign diseases of the colon is well established. Laparoscopic surgery for malignant diseases of the colon has been awaiting the results of studies of the oncological results. Now several randomised studies have demonstrated oncological results equal to or better than those of open surgery. The aim of this study was to show the initial experience of laparoscopic surgery of the colon in a Danish hospital surgical department. MATERIALS AND METHODS: Forty patients were included in the study. They had a planned laparoscopic resection of the sigmoid colon in the period from January 2004 to February 2005. RESULTS: Thirty-six patients had the operation done laparoscopically. Four operations were converted to open operations. Four patients had major complications. The median postoperative time in hospital was three days and five days for malignant and benign disease, respectively. In the case of malignant disease, the median number of lymph nodes in the specimen was eight, and the median distance from the resection line to the tumour was 4.5 cm. CONCLUSION: Our results seems to show that if with sufficient laparoscopic expertise, laparoscopic resection of the colon for both benign and malignant diseases can be performed with the advantage of earlier convalescence and fewer days in hospital. The histopathology findings in the case of malignant disease do not differ from those of open surgery.