Choloperitoneum causes extensive coloring of the abdominal wall skin.

Laparoscopic cholecystectomy, because it is the less invasive surgical procedure, has been established as the procedure of choice for the treatment of patients with symptomatic gallbladder stones. However, bile leakage after laparoscopic cholecystectomy should not be overlooked. It is generally due to a minor biliary complication, although it can sometimes herald a major duct injury. Bile leakage rates of 1.2% to 4.0% in laparoscopic cholecystectomies have been reported, which are higher than the incidence with open cholecystectomies.

Rectus abdominis muscle malignant fibrous histiocytoma causing a large abdominal wall defect: reconstruction with biological mesh.

Malignant fibrous histiocytoma (MFH) is a common soft tissue sarcoma usually involving limbs and retroperitoneum. MFH of the rectus abdominis muscle is extremely rare. Surgery in similar cases leads to large abdominal wall defects needing reconstruction. Biological and synthetic laminar absorbable prostheses are available for the repair of hernia defects in the abdominal wall. They share the important feature of being gradually degraded in the host, resulting the formation of a neotissue. We herein report the case of an 84-year-old man with MFH of the rectus abdominis muscle which was resected and the large abdominal wall defect was successfully repaired with a biological mesh.

Recurrent Urinary Tract Infections due to Asymptomatic Colonic Diverticulitis.

Colovesical fistula is a common complication of diverticulitis. Pneumaturia, fecaluria, urinary tract infections, abdominal pain, and dysuria are commonly reported. The authors report a case of colovesical fistula due to asymptomatic diverticulitis, and they emphasize the importance of deeply investigate recurrent urinary tract infection without any bowel symptoms. They also briefly review the literature.

Strangulated intestinal hernia through a drain site.

INTRODUCTION: Intra-abdominal drains have been widely used in order to prevent intra-abdominal fluid accumulation and detection of anastomotic leakage. PRESENTATION OF CASE: We herein report a case of small bowel herniation followed by strangulation in an 82 year old woman who had undergone sigmoidectomy for colorectal cancer. DISCUSSION: Although several complications related to drain usage such as drainsite infection, hemorrhage and intestinal perforation may occur, intestinal incarceration through drain site is rarely reported. CONCLUSION: Drains must be used with caution and only if indicated. Careful insertion, regular post-operative or post-removal inspection is strongly recommended.

Traumatic mesenteric cyst after blunt abdominal trauma.

Mesenteric cysts are rare abdominal tumors of unclear histologic origin, usually asymptomatic. Post-traumatic mesenteric cyst usually results as a consequence of a mesenteric lymphangitic rupture or a hematoma followed by absorption and cystic degeneration. The preoperative histological and radiological diagnosis is difficult. We present the case of a 45-year-old male patient with sizable, palpable abdominal tumor, the gradual swelling of which the patient himself combined with the blunt abdominal trauma he acquired from an opponent's knee in a football game 5 months ago.

Primary retroperitoneal mucinous cystadenoma of borderline malignancy in a male patient. Case report and review of the literature.

BACKGROUND: Primary retroperitoneal mucinous cystadenoma of borderline malignancy represents a rare tumor, with unclear histogenesis, concerning almost exclusively women. Only two cases concerning male patients have been reported. CASE REPORT: We herein report a case of a 37 year old man undergone laparotomy for a sizable retroperitoneal tumor resulting after the histological examination to a primary retroperitoneal mucinous cystadenoma of borderline malignancy. CONCLUSION: This is the third case of primary retroperitoneal mucinous cystadenoma of borderline malignancy in a male patient reported in the literature. The preoperative diagnosis is impossible. Laparotomy constitutes the only diagnostic and curative approach.

Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report.

INTRODUCTION: Gout is a common inflammatory arthritis caused by articular precipitation of monosodium urate crystals. It usually affects the first metatarsophalangeal joint of the foot and less commonly other joints, such as wrists, elbows, knees and ankles. CASE PRESENTATION: We report the case of a 75-year-old Caucasian man with tophaceous multiarticular gout, soft-tissue involvement and ulcerated tophi on the first metatarsophalangeal joint of the left foot, on the first interphalangeal joint of the right foot and on the left thumb. CONCLUSION: Ulcers due to tophaceous gout are currently uncommon considering the positive effect of pharmaceutical treatment in controlling hyperuricemia. Surgical treatment is seldom required for gout and is usually reserved for cases of recurrent attacks with deformities, severe pain, infection and joint destruction.

Sclerosing Mesenteritis: Diverse clinical presentations and dissimilar treatment options. A case series and review of the literature.

Sclerosing mesenteritis (SM) is a rare pathological condition affecting the mesentery. It is a benign, non-specific inflammation of the adipose tissue of the mesentery of the small intestine and colon. It is characterized by a variable amount of chronic fibrosis. Its etiology is unknown, the pathogenesis is obscure, while the pathological characteristics of the disease are unspecific. The initial clinical presentation varies from typically asymptomatic to that of an acute abdomen. The diagnosis is suggested by computed tomography but is usually confirmed by surgical biopsies. Treatment is largely empirical; it is decided upon on the basis of the clinical condition of the patient, and usually a few specific drugs are used. Surgical resection is sometimes attempted for definitive therapy, although the surgical approach is often limited. We will present five cases of SM as well as a review of the available literature in order to state and compare a variety of clinical presentations, diverse possible etiologies and dissimilar treatment options.

Multiple giant diverticula of the jejunum causing intestinal obstruction: report of a case and review of the literature.

Multiple diverticulosis of jejunum represents an uncommon pathology of the small bowel. The disease is usually asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain or discomfort. Related complications such as diverticulitis, perforation, bleeding or intestinal obstruction appear in 10-30% of the patients increasing morbidity and mortality rates. We herein report a case of a 55 year-old man presented at the emergency department with acute abdominal pain, vomiting and fever. Preoperative radiological examination followed by laparotomy revealed multiple giant jejunal diverticula causing intestinal obstruction. We also review the literature for this uncommon disease.

Synchronous early primary adenocarcinoma of both rectum and gallbladder. Report of a case.

BACKGROUND: Synchronous early primary cancers are rare and in addition synchronous adenocarcinoma of both rectum and gallbladder is extremely rare. CASE REPORT: We report an unusual case of synchronous early primary adenocarcinoma of rectum and gallbladder. The patient was a 72-year-old woman with complaints of bloody stools and constipation. An endoscopy revealed adenocarcinoma of the lower rectum. A through preoperative investigation showed also cholelithiasis. The patient underwent abdominoperineal resection and cholecystectomy. The histopathological diagnosis was well to middle differentiate adenocarcinoma of the gallbladder (T2, N0, M0; stage II) and middle differentiate adenocarcinoma of the rectum (T2, N0, M0; stage II). CONCLUSION: For the cases of extracolonic primary cancer associated with colorectal primary carcinoma, Warren and Gates' diagnostic criteria are used. All patients with colorectal carcinoma, should undergo a throughout preoperative examination to exclude the possibility of synchronous early primary cancers.