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1.
J Surg Case Rep ; 2019(5): rjz159, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31139340

RESUMO

Venous aneurysms rarely present as a painless mass; they are usually symptomatic and present with pain, swelling, and sometimes, embolism. We present a 41-year-old man who presented with a painless swelling involving the right side of the neck. Examination of the neck revealed a soft, compressible, non-pulsatile and non-tender swelling above the right sternoclavicular joint. Doppler ultrasound showed a well-defined compressible cystic lesion measuring 4.2 × 1.9 cm causing indentation of the right sternocleidomastoid muscle. Further imaging studies confirmed the diagnosis of an aneurysmal dilation in the right internal jugular vein. An excisional biopsy of the aneurysm was performed using a longitudinal incision in the skin at the anterior border of the right sternocleidomastoid muscle and excisional venotomy was performed. Histopathological examination showed a cystic structure containing organizing blood clots surrounded by a thick fibrous wall. A follow-up neck ultrasound performed postoperative showed a patent internal jugular vein.

2.
J Surg Case Rep ; 2019(2): rjz026, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30815247

RESUMO

Herniation of gastrointestinal structures through the foramen of Winslow is rare, with patients presenting with nonspecific symptoms. We describe a 47-year-old woman who presented with generalized, intermittent, colicky abdominal pain for a duration of 4 days. An abdominal computed tomography scan revealed findings consistent with herniation of the ileocecal junction through the foramen of Winslow. Laparoscopic assisted internal hernia reduction with ileocecal resection and side-to-side ileocolic anastomosis were done. The cecum and terminal ileum were resected due to signs of ischemia. Her postoperative was uneventful, and she was discharged in the second postoperative day. She did not show any signs or symptoms suggestive of complications or recurrence during her follow-up.

3.
J Surg Case Rep ; 2019(2): rjz033, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30788105

RESUMO

Intestinal obstruction is a rare complication of the administration of activated charcoal. We describe a 22-year-old patient who had received multiple-dose activated charcoal for carbamazepine intoxication. The patient presented with sudden-onset abdominal pain after discharge from the emergency room, and abdominal imaging examinations revealed findings consistent with small bowel obstruction. Laparoscopic-assisted exploration of the abdomen was offered, and a hard obstructing charcoal mass was found in the small bowel. Clinicians should be aware of the rare occurrence of gastrointestinal complication or obstruction following the administration of multiple-dose activated charcoal, especially in patients who ingested a drug that is potentially antiperistaltic.

4.
J Surg Case Rep ; 2018(7): rjy149, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29992004

RESUMO

Appendicular schwannomas are very rare condition with nonspecific clinical symptoms and frequently recognized during pathological examination. They arise less frequently in the gastrointestinal tract and comprise ~1% of all malignant gastrointestinal tumours. We presented a rare case of an appendicular schwannoma that was discovered incidentally in a 25-year-old student diagnosed with appendicular mucocoele with a suspected obstructing tumoural lesion based on computed tomography findings. A colonoscopy examination showed a bulging, nodular, erythematous lesion at the base of the caecum (appendiceal orifice). Biopsies showed mixed inflammatory infiltration in the lamina propria, with lymphoid-filled formations. No evidence of dysplasia or neoplasia. Tumour markers were negative. Appendicular neoplasms, such as schwannomas of the appendix, are rarely associated with nonspecific clinical symptoms and are frequently recognized during pathological examination of the resected appendix. Laparoscopic surgery with a clear resection margin is the cornerstone of treatment for appendicular schwannoma, and it is associated with a favourable prognosis.

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