Case report: a gastric lipoma in a morbid obese man.

We report a case of a 54-year-old, morbid obese man who presented with melena, hematemesis and fatigue over the last two days. The cause of this upper gastrointestinal bleeding was found on endoscopy which revealed an ulcerated submucosal mass in the gastric antrum. The haemorrhagia could not be stopped with injection of Aethoxysclerol. The mass was resected by an antrectomy with Roux-en-Y reconstruction. Histologic examination showed a lipoma. No further treatment was necessary. In this case report, we would like to stress the need for histologic diagnosis to differentiate a benign gastric lesion from a malign.

Sigmoid volvulus caused by a large faecalith. Case report.

We describe a case in which the presence of a large faecalith in a 43-year-old man was the probable cause of a sigmoid volvulus.

The abdominal cocoon. A case report.

The abdominal cocoon, or idiopathic sclerosing encapsulating peritonitis, is a rare cause of intestinal obstruction. This rare condition, in which the small intestine is encased in a thick fibrous membrane, has been reported predominantly in females. Despite some reports of a preoperative diagnosis, in the majority of cases diagnosis is only made at laparotomy for acute or subacute intestinal obstruction. Treatment consists of resection of the membrane with lysis of adhesions. We present a case of abdominal cocoon in a man where early preoperative diagnosis by radiological evaluation was overlooked. A better awareness of this condition may result in early diagnosis and proper management, thus avoiding unnecessary bowel resections and bad outcomes.

Necrolytic migratory erythema: first symptom of a glucagonoma. A case report.

Necrolytic migratory erythema (NME) is a rare skin condition consisting of migrating areas of erythema with blisters that heal with hyperpigmentation. NME is a pathognomonic feature of a glucagonoma. When confronted with a xerosis cutis one should always exclude the possibility of a NME caused by a glucagonoma as demonstrated in this case report where the rash was wrongly attributed to an acrodermatitis enteropathica due to zinc deficiency. We describe a case of a glucagonoma with its classic features, diagnosis and treatment.

Primary angioleiomyosarcoma of the lesser omentum.

Primary omental leiomyosarcomas are rare intra-abdominal tumours. A few cases only have been reported in the literature. We present a case of a 79-year old woman, whose tumour was surgically removed. We include a hort review of the literature.

Rectourethral fistula due to Crohn's disease.

Fistulas between the large bowel and the prostatic urethra, due to Crohn's disease, are very uncommon. Pneumaturia and an abnormal urethral discharge are the most common symptoms. Diagnosis is made by a voiding cystourethrogram or a retrograde urethrography. Treatment is usually difficult with a high percentage of recurrence. A well documented case is presented.

[Small intestinal ulceration and stenosis induced by non-steroidal anti-inflammatory agents]. / Dundarmulceratie en -stenose geïnduceerd door niet-steroïdale anti-inflammatoire farmaca.

UNLABELLED: We report a case who developed a small bowel ulceration in a long segment of distal duodenum and proximal jejunum, a few days after he had taken high doses of diclofenac. After a month, it was complicated by a stenosis of the same segment. Nonsteroidal antiinflammatory drugs have recently been recognised as a possible etiologic factor of small bowel ulcerations. Clinical findings are aspecific. Complications of small bowel ulcerations are: obstruction, perforation or bleeding. Those have to be treated by surgery. We proposed a physiopathologic model and correlated it with histological findings. CONCLUSION: careful prescription of those drugs has to be pursued and one should think about a small bowel ulceration in a patient with an abdominal syndrome, who takes non-steroidal antiinflammatory drugs.

[Volvulus of the cecum and sigmoid]. / Volvulus van het caecum en sigmoid.

Five cases of volvulus, four of the sigmoid and one of the cecum are presented. Etiology, symptomatology, diagnosis and therapy are discussed.

Icterogenic hepatocellular carcinoma and polygonal cell carcinoma with fibrous stroma (fibrolamellar hepatocarcinoma).

Hepatocellular carcinoma (HCC) associated with obstructive jaundice by direct invasion or migration of tumor tissue into the biliary system has been described as icterogenic hepatocellular carcinoma (IHCC) or icteric type hepatoma. Fifty-eight such cases have been reported in literature since 1947. Curative treatment and prognosis depend directly on early appearance of icterus and its correct interpretation. Recently, attention has been paid to polygonal cell carcinoma with fibrous stroma (PCFS) as a well differentiated, low grade and transient type of HCC, probably distinguishable from classic HCC by etiological and epidemiological features. The combination of IHCC and PCFS is very rare; to our knowledge only one such case has been reported yet. We had the opportunity to observe and treat such a case, which will be reported in this article and will be compared with cases described in the literature.

[Volvulus of the stomach]. / Volvulus van de maag.

Volvulus of the stomach. On occasion of three observations the volvulus of the stomach is studied in the light of recent advances of the literature. Different types of gastric volvulus are defined by etiopathogenic analysis. Symptomatology and diagnosis are examined and possibilities of treatment are emphasized. The therapeutic behaviour which is required towards this rare affection is discussed.

[Formation of a phytobezoar following surgery of the stomach. Review of the literature]. / Fytobezoar vorming na heelkunde op de maag. Overzicht van de literatuur.

Phytobezoar after partial gastrectomy. An observation on phytobezoar formation after partial gastrectomy, attended by an intestinal obstruction is presented. According to a review of the literature bezoar formation following gastric surgery seems to develop in the stomach after vagotomy, and rather in the small intestine after partial gastrectomy. The etiopathogenesis of this phenomenon is analysed, and the physiopathology, the clinical manifestation, the diagnosis and therapeutic possibilities of this affection are discussed.