Rectal perforations caused by cleansing enemas in chronically constipated patients: Two case reports.

Constipation is a common disease that is frequently treated with cleansing enemas. Enemas are considered as effective and in some cases may cause serious adverse events. Iatrogenic perforations due to enemas lead to adverse outcomes in elderly patients with a poor general condition. Perforation remains an infrequent and rarely reported complication. In this work, we describe the cases of two patients with rectal perforation caused by a cleansing enema. The first patient had rectal perforation that led to a para-rectal abscess and the second patient had generalized peritonitis caused by rectal perforation.

Laparoscopic treatment of gastrointestinal stromal tumors located at the duodenojejunal junction.

Gastrointestinal stromal tumors are the most common subepithelial tumors of the gastrointestinal tract. Gastrointestinal stromal tumors are commonly detected in the stomach followed by the small intestine. Surgery for gastrointestinal stromal tumors affecting the duodenojejunal junction is technically challenging because of the anatomical complexity of this area. A 56-year-old woman visited the outpatient clinic with the chief complaint of melena associated with dizziness from 5 days ago. Abdominal computed tomography revealed an enhancing small bowel mass measuring 4 cm × 5 cm in the left upper abdomen abutting the duodenojejunal junction. She underwent successful laparoscopic small bowel segmental resection of the duodenojejunal junction area. Laparoscopic segmental resection with side-to-side duodenojejunostomy for a gastrointestinal stromal tumor at the duodenojejunal junction is an advanced and challenging procedure requiring experience and a good surgical technique.

Laparoscopic management of massive intraperitoneal haemorrhage caused by an acute gallbladder perforation.

Laparoscopic cholecystectomy is the gold standard for managing the treatment of patients with symptomatic gallstone disease. Certain patients with acute cholecystitis will develop gallbladder perforation (GP). Furthermore, massive intraperitoneal haemorrhage following perforation is a rare complication. The high morbidity and mortality rates associated with this condition are due to delays in the diagnosis and treatment since signs and symptoms of perforation do not differ significantly from those of uncomplicated cholecystitis. Severe inflammation and haemodynamic instability necessitate exploratory laparotomy in many patients. To the best of our knowledge, no study had described laparoscopic completion cholecystectomy for massive intraperitoneal haemorrhage caused by an acute GP. Laparoscopy can be an option for the management of these patients, in selected cases and with available expertise.

Gastric Calcifying Fibrous Tumor Manifesting as a Subepithelial Tumor.

A gastric subepithelial tumor is a common finding during upper gastric endoscopy. The differential diagnosis of such lesions is broad, and sometimes a rare disease can be diagnosed. A calcifying fibrous tumor (CFT) is a rare, benign mesenchymal tumor that usually affects children and young adults. To our knowledge, a CFT of the tubular gastrointestinal tract is very rare with fewer than 30 cases of gastric CFTs reported in the literature.

Peritoneal Simple Mesothelial Cyst Misdiagnosed as a Gastric Subepithelial Tumor.

Peritoneal simple mesothelial cysts are very rare mesenteric cysts of mesothelial origin. A peritoneal simple mesothelial cyst may be misdiagnosed, even by advanced diagnostic tools, as a gastric subepithelial tumor. A few cases that were misdiagnosed as a regarding peritoneal simple mesothelial cysts. To the best of our knowledge, there are no reports regarding peritoneal simple mesothelial cysts.