ABSTRACT
This is a case report of a 73-year-old man with a small bowel obstruction secondary to an incarcerated paracaecal hernia. His large right inguinal hernia, initially suspected as a potential source of obstruction, turned out to be a red herring. Congenital internal hernias are a very rare cause of bowel obstruction. In this report we review the literature and embryology behind these uncommon occurrences.
Subject(s)
Cecal Diseases/complications , Hernia/complications , Ileal Diseases/etiology , Intestinal Obstruction/etiology , Aged , Cecal Diseases/embryology , Cecal Diseases/pathology , Cecal Diseases/surgery , Hernia/embryology , Hernia/pathology , Hernia, Inguinal/complications , Herniorrhaphy , Humans , MaleABSTRACT
Segmental dilatation of the colon is a rare entity. The authors report unique case of segmental dilatation of the cecum and ascending colon with high anorectal malformation in a newborn, and the possible embryogenesis of this condition is discussed.
Subject(s)
Abnormalities, Multiple/embryology , Anus, Imperforate/embryology , Colonic Diseases/congenital , Rectum/abnormalities , Abnormalities, Multiple/pathology , Abnormalities, Multiple/surgery , Anus, Imperforate/surgery , Cecal Diseases/congenital , Cecal Diseases/diagnosis , Cecal Diseases/embryology , Cecal Diseases/surgery , Colon/blood supply , Colon/embryology , Colonic Diseases/diagnosis , Colonic Diseases/embryology , Colonic Diseases/surgery , Diagnosis, Differential , Dilatation, Pathologic/congenital , Dilatation, Pathologic/diagnosis , Dilatation, Pathologic/embryology , Dilatation, Pathologic/surgery , Hirschsprung Disease/diagnosis , Humans , Infant, Newborn , Male , Mesenteric Artery, Superior/abnormalities , Mesenteric Artery, Superior/embryology , Mesenteric Artery, Superior/pathology , Rectum/embryology , Rectum/surgeryABSTRACT
Surgeons should be familiar with surgery of the cecum and appendix because the diseases of this region, especially appendicitis, are the most common indications for surgical exploration. Usually, diagnosis of appendicitis and appendectomy are not difficult, but atypical location of the appendix or other anatomic anomalies can make the diagnosis of appendicitis and appendectomy difficult. In cases of atypical anatomy or diffuse clinical picture, especially in young adults or elderly patients, the spectrum of embryologic and anatomic anomalies must be kept in mind to make the correct treatment decision for individual patients. If doubt persists, explorative laparotomy must be performed to avoid overlooking rare, acute, intra-abdominal abnormalities.
Subject(s)
Appendiceal Neoplasms/surgery , Appendicitis/surgery , Cecal Diseases/surgery , Cecal Neoplasms/surgery , Adult , Appendectomy , Appendiceal Neoplasms/embryology , Appendiceal Neoplasms/pathology , Appendicitis/embryology , Appendicitis/pathology , Appendix/embryology , Appendix/pathology , Cecal Diseases/embryology , Cecal Diseases/pathology , Cecal Neoplasms/embryology , Cecal Neoplasms/pathology , Cecum/embryology , Cecum/pathology , Cecum/surgery , HumansABSTRACT
Cecal volvulus is a malrotational abnormality of the intestine that causes obstruction. Diagnosis is difficult and, if delayed, the results may be intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined from physical and laboratory findings. Although not always conclusive, contrast radiography may be helpful; however, laparotomy is often required for definitive diagnosis and therapy. If vascular compromise of the cecum is found, right hemicolectomy is the treatment of choice. In the absence of ischemia, decompressive tube cecostomy, simple detorsion, and cecopexy have all been recommended, but the optimal treatment is a matter of controversy.
