ABSTRACT
Accurate identification of anatomical variations in the biliary tree is crucial in hepatobiliary surgeries, including the widely performed laparoscopic cholecystectomy. Coexisting anomalies, though rare, present challenges for surgeons. This case study follows a 43-year-old female post-sleeve gastrectomy, diagnosed with mild gallstone pancreatitis and choledocholithiasis, who underwent early cholecystectomy. Intraoperatively, a 3 mm aberrant right hepatic duct and three 1 mm subvesicular ducts were identified. Recognizing these variants is pivotal for surgical success. Utilizing preoperative imaging, intraoperative vigilance, and advanced techniques like cholangiography are essential in preventing complications. Continuous education and collaborative experiences among surgical teams are integral in enhancing patient safety in these complex procedures.
ABSTRACT
Gastrointestinal stromal tumors (GISTs) are a common type of soft tissue sarcoma that originates from the interstitial cells of Cajal in the gastrointestinal (GI) tract. These tumors usually affect people above 50 years of age and can be difficult to diagnose, as symptoms can be vague and nonspecific, with some patients remaining asymptomatic. Early diagnosis and treatment are crucial because GISTs can be aggressive and may metastasize. We present a case of a 74-year-old man who presented to our hospital with GI bleeding and anemia. Despite initial investigations, the source of bleeding was not identified until capsule endoscopy and then balloon enteroscopy revealed an ulcerated mass in the jejunum. The tumor was successfully removed using a minimally invasive laparoscopic approach, and the histopathologic report confirmed the diagnosis of GIST. The patient had an uneventful postoperative course. This case highlights the importance of considering GISTs in the differential diagnosis of obscure GI bleeding. A multidisciplinary approach is essential to ensure the best outcomes for these patients. Additionally, the use of minimally invasive surgery should be considered whenever possible to minimize postoperative complications and promote faster recovery.
ABSTRACT
Foreign body ingestion is a common condition in daily practice; fortunately, most cases do not require endoscopic or surgical treatment, as most foreign bodies pass through the intestine without injuring it. Although mainly seen in children, adults can also be affected, especially in accidental situations and suicide attempts. Therefore, the clinical history and the environment in which the event occurred are essential for a rapid diagnosis. This can be even more challenging as most adult patients are rarely aware of ingestion. Therefore, a high index of suspicion is necessary. Therapy will depend on the foreign body's size, shape and material; treatment should not be delayed if complications are detected. We present a case of a 34-year-old man who accidentally swallowed the mold of his teeth while undergoing a dental procedure. Subsequently, he presented with an intestinal obstruction that required surgery. Fortunately, he made a full recovery.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Evisceration of the small bowel through the vagina is an extremely rare condition and a life-threatening surgical emergency. Complications associated with this condition include bowel ischemia, abdominal sepsis, and deep vein thrombosis. Therefore, prompt surgical consultation and treatment are crucial as delay in treatment can lead to a grim outcome. CASE PRESENTATION: We report the case of a 50-year-old female obese patient with a past medical history of uterine surgery. During a cough episode, she experienced sudden transvaginal evisceration that required emergent surgery. Thankfully she fully recovered and is doing well. DISCUSSION AND CONCLUSIONS: Transvaginal evisceration is a life-threatening and extremely rare pathology; it requires urgent diagnosis and surgical intervention since bowel viability can be compromised. During these rare events, interdisciplinary surgical cooperation is vital to obtain the best possible outcome for patients.
