ABSTRACT
We report a male patient with carcinoma arising on the basis of neglected sacrococcygeal pilonidal sinus disease. Following initial operation, performed without suspicion of malignancy, histology demonstrated cellular atypia and an increased mitotic rate. A second, wider tissue excision was recommended but the patient declined further surgery. Two years later, he presented with fungating carcinoma involving the rectum but again declined surgery. This rare case demonstrates that the presence of carcinoma should be suspected in long-standing, although innocent-looking, pilonidal sinus disease. In the circumstance of uncertain histologic diagnosis, more generous surgical sampling is required. Every effort must be made to overcome patient's reluctance to accept a second, possibly life-saving procedure.
Subject(s)
Carcinoma, Squamous Cell/pathology , Pilonidal Sinus/pathology , Rectal Neoplasms/pathology , Chronic Disease , Fatal Outcome , Humans , Male , Middle Aged , Treatment RefusalSubject(s)
Abdominal Injuries , Ileum/injuries , Mesentery/injuries , Wounds, Gunshot , Abdominal Injuries/complications , Abdominal Injuries/diagnosis , Abdominal Injuries/surgery , Adult , Debridement , Emergencies , Humans , Laparoscopy/methods , Laparotomy/methods , Male , Predictive Value of Tests , Time Factors , Wounds, Gunshot/complications , Wounds, Gunshot/diagnosis , Wounds, Gunshot/surgerySubject(s)
Common Bile Duct Diseases/surgery , Echinococcosis, Hepatic/surgery , Adult , Female , Humans , LigamentsABSTRACT
A patient is described who was found to have both eosinophilic enterocolitis and visceral neuropathy with chronic idiopathic intestinal pseudo-obstruction. The etiology and pathogenesis of this rare combined disorder of the gastrointestinal tract are discussed. Although eosinophilic enterocolitis is amenable to conservative treatment, surgery may be necessary for palliation in selected patients with pseudo-obstruction due to visceral neuropathy.
Subject(s)
Enterocolitis/complications , Eosinophils/pathology , Intestinal Pseudo-Obstruction/complications , Myenteric Plexus/pathology , Adult , Chronic Disease , Enterocolitis/pathology , Gastrointestinal Diseases/complications , Gastrointestinal Diseases/pathology , Gastrointestinal Motility , Humans , Intestinal Pseudo-Obstruction/pathology , MaleABSTRACT
A case of an anomalous extrahepatic biliary system is reported in which the common hepatic duct was found to enter the gallbladder, whereas the cystic duct drained the entire biliary system into the duodenum. In this case, the gangrenous gallbladder was removed and the continuity between the common hepatic duct and the gastrointestinal tract was restored by means of Roux-en-Y anastomosis. The identification and treatment options of this rare anomaly are briefly discussed.
