Superior mesenteric vein thrombosis as a complication of cecal diverticulitis: A case report.

Pylephlebitis is an uncommon complication of uncontrolled intra-abdominal infection that is associated with high morbidity and mortality. We present our experience with a unique case of cecal diverticulitis and septic thrombophlebitis of the superior mesenteric vein that was promptly diagnosed with high-resolution imaging and blood cultures. Antibiotic and anticoagulation therapy was instituted on confirming the diagnosis with magnetic resonance imaging (MRI) to control the infection and prevent propagation of the thrombus. Our case report raises awareness about a rare and potentially fatal condition and provides appropriate imaging supplementation to aid in timely diagnosis.

Diagnosis and therapy of primary hypertrophic pyloric stenosis in adults: case report and review of literature.

Adult idiopathic hypertrophic pyloric stenosis (AIHPS) is a misleading anatomic and radio-clinical entity of unknown etiology. Only about 200 cases have been reported in the literature. It is a benign disease resulting from hypertrophy of the circular fibers of the pyloric canal. Despite the recent progress in radiography and endoscopy, it is very hard to define hypertrophic stenosis in adults. Differentiation of primary from secondary pyloric stenosis is frequently a task of the pathologist rather than the surgeon. The main therapy is surgical, although endoscopic dilatation has been tried. There remains controversy over the best surgical approach. A case is reported of a 48-year-old male patient with AIHPS who was subjected to distal gastrectomy. This paper discusses the possible causes of the disorder, the recommended diagnostic steps, and the different surgical approaches.

Annular pancreas in the adult: two case reports and review of more than a century of literature.

This paper brings the diagnosis and treatment of this interesting yet infrequent condition to contemporary standards through an assessment of past literature and a re-evaluation of the problem in view of technological advances. Two cases of annular pancreas are cited with a review of the last 183 years of literature. Only 100 cases, however, were reported in enough detail to examine outcomes in general and to arrive at a reasonable conclusion in terms of recommendations for diagnosis and operative intervention in adult annular pancreas. Two observations are brought to light. Despite all present diagnostic tools including endoscopic retrograde cholangiopancreatography diagnosis at best is made in only 60 per cent of patients preoperatively. Intraoperative expertise remains the best diagnostic modality available to date. Enteroenterostomy seems to be the intervention of choice for a multitude of anatomic and physiologic reasons and with a wide array of surgical options available when additional factors need to be addressed.