Rectus Abdominis Endometrioma after Caesarean Section.

Isolated rectus abdominis muscle endometriosis is very uncommon with less than 20 case reports being published to date since its first description in 1984 by Amato and Levitt. We report another case of isolated rectus abdominis endometriosis in a 37-year-old patient with a previous caesarian section. We also discuss the diagnostic and treatment particularities in these patients. In our case, the treatment was only surgical and currently the patient is disease-free during the 24-month follow-up.

Torsion of an appendiceal mucinous cystadenoma. Report of a case and review of literature.

Vermiform appendix torsion is rare, and even more uncommon is the volvulus of appendiceal mucinous tumors. To our knowledge, only nine cases of torsion of the vermiform appendix associated with appendiceal mucinous neoplasms have been reported up to date. We report a case of secondary torsion of the vermiform appendix with mucinous cystadenoma in a 30-year-old man. The symptoms were consistent with acute appendicitis. Diagnostic laparoscopy revealed a mucinous tumor of the appendix with a 360 degrees twisted appendix. In order to avoid peritoneal dissemination open appendectomy was performed. The final pathologic diagnosis was a mucinous cystadenoma of the appendix. The postoperative recovery was uneventful. Secondary torsion of vermiform appendix with mucinous cystadenoma is a rare entity. Correct preoperative diagnosis is unlikely. Open appendectomy is the standard of care for benign mucinous appendiceal tumors. Furthermore, it is important to prevent spillage of the appendiceal mucocele content.

Non-operative treatment for gall-stone ileus - a case report.

Gall-stone intestinal obstruction (GSO) is an unusual form of mechanical obstruction and a rare complication of cholelithiasis. The treatment options are controversial, usually the management is surgical but associated with significant morbidity and mortality. A spontaneous evacuation of the gall-stone that had induced GSO is even more exceptional, only few reports being published up to date. We report the case of an 81-year-old female patient presenting GSO admitted to our department due to abdominal pain and vomiting. Computed tomography revealed pneumobilia, distention of the ileum and a calcified mass in the small bowel lumen. The diagnosis of GSO was established, but since the gall-stone was <25 mm and severe cardiorespiratory co-morbidities conservative treatment was initiated and spontaneous evacuation of the gall-stone was obtained. Diagnostic and management modalities of GSO as well as literature reviews are reported.