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1.
Asian J Endosc Surg ; 15(3): 629-632, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35052013

ABSTRACT

A 55-year-old woman receiving treatment for anorexia nervosa presented with abdominal pain and right thigh pain. Her body mass index was 12.9 kg/m2 . Computed tomography showed fluid storage in the distal side of the right obturator foramen and revealed a dilated small bowel without a starting point of obstruction. We diagnosed a naturally reduced incarcerated right obturator hernia and performed elective surgery with a laparoscopic approach for hernia repair the next day. Intraperitoneal observation revealed bilateral obturator hernias and a left direct-type inguinal hernia. Transabdominal preperitoneal hernioplasty was performed using two self-gripping polyester meshes for bilateral obturator hernia repair and a lightweight 3D-shaped mesh for left inguinal hernia repair. Women with emaciation caused by anorexia nervosa may be more likely to have complex hernias, including obturator hernia, and laparoscopic approaches may be useful for preoperatively diagnosed nonstrangulated obturator hernias.


Subject(s)
Anorexia Nervosa , Hernia, Inguinal , Hernia, Obturator , Laparoscopy , Anorexia Nervosa/surgery , Emaciation/surgery , Female , Hernia, Inguinal/complications , Hernia, Inguinal/surgery , Hernia, Obturator/complications , Hernia, Obturator/diagnostic imaging , Hernia, Obturator/surgery , Herniorrhaphy/methods , Humans , Laparoscopy/methods , Middle Aged , Surgical Mesh
2.
J Neurooncol ; 79(2): 197-201, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16598421

ABSTRACT

The association of weight loss and pediatric brain tumors that affect the diencephalon or brain stem with weight loss is a recognized, but not fully understood phenomenon. Tumors located in the hypothalamic region may induce the diencephalic syndrome (DS), which is characterized by profound emaciation with almost complete loss of subcutaneous fatty tissue. Tumors that compress or infiltrate the brain stem rarely cause both psychological disturbance and emaciation. The clinical presentation may be different, depending on the location of the lesion and age of the patient. In this report we present an unusual case of severe emaciation in a 4(9)/(12)-year-old girl with a juvenile pilocytic astrocytoma of the hypothalamic region and brain stem with neuroaxis dissemination. This case illustrates the importance of considering intracranial mass-lesions in the differential diagnosis of weight loss, psychological disturbance and atypical eating disorder. We discuss the importance of tumor multifocality and the role of patient age in the clinical presentation with reference to the literature.


Subject(s)
Astrocytoma/pathology , Brain Neoplasms/pathology , Emaciation/etiology , Feeding and Eating Disorders/etiology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Astrocytoma/complications , Astrocytoma/drug therapy , Brain Neoplasms/complications , Brain Neoplasms/drug therapy , Brain Stem/pathology , Child, Preschool , Diagnosis, Differential , Emaciation/pathology , Emaciation/surgery , Feeding and Eating Disorders/pathology , Feeding and Eating Disorders/surgery , Feeding and Eating Disorders of Childhood/diagnosis , Female , Humans , Hypothalamus/pathology , Spinal Cord Neoplasms/complications , Spinal Cord Neoplasms/secondary , Treatment Outcome
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