Multiple thoracic and abdominal foregut duplication cysts: A case report.

BACKGROUND: Congenital enteric duplication cysts are tubular or cystic structures that normally lie alongside the gastrointestinal (GI) tract. Enteric duplication cysts are typically solitary lesions that occur anywhere near the GI tract from the neck to the rectum, but having multiple duplication cysts is rare, and presentation within the pancreas is extremely rare. CASE SUMMARY: We herein demonstrate a case of esophageal, gastric, and gastric-type duplication cyst of the pancreas in a seventeen-month-old girl who presented with failure to thrive, abdominal pain, vomiting, hematemesis, and melena since the age of three months. The cysts were excised by thoracoscopy and laparoscopy in the same setting. To our knowledge, no such case has been published. CONCLUSION: Enteric duplications can occur throughout the entire alimentary tract. When they occur in the pancreas, they present a formidable challenge in both diagnosis and treatment. Due to the risk of complications and malignant transformation, surgical removal is the recommended treatment of all duplication cysts.

Perforated duodenal ulcer secondary to deferasirox use in a child successfully managed with laparoscopic drainage: A case report.

BACKGROUND: A perforated gastroduodenal ulcer is rarely observed in children. Certain medications have been reported to cause ulcerations. Deferasirox, an iron chelating agent, has been previously reported to be associated with the development of gastroduodenal ulcers. CASE SUMMARY: We report a case of a 3-year-old boy who was diagnosed with beta thalassemia major and treated with deferasirox. He presented to the emergency department with an acute abdomen. A perforated duodenal ulcer was suspected after X-ray imaging and laparoscopic exploration. It was successfully managed with laparoscopic washout and drainage. CONCLUSION: Due to the rarity and severity of this case, it is a reminder that prevention and early recognition of gastrointestinal complications in patients receiving deferasirox are crucial. Minimally invasive laparoscopic surgery is both safe and feasible to treat perforated duodenal ulcers in selected patients.

A Right Video-Assisted Thoracoscopic Enucleation of a Calcified Esophageal Leiomyoma: A Case Report.

BACKGROUND Benign esophageal tumors are considered rare, and most commonly are leiomyomas with the incidence of 0.005%. They arise intramurally in the distal two-thirds of the esophagus and are multiple in about 5% of patients. Leiomyoma lesions can mimic esophageal cancer making the diagnosis more challenging. Many cases are asymptomatic, up to 15%-50%, and most cases are discovered incidentally during esophagogastroduodenoscopy (EGD) and other procedures. The treatment of choice for symptomatic leiomyomas to relieve the compression is surgical enucleation with either an open thoracotomy, submucosal tunneling endoscopic resection, a video-assisted thoracoscopic approach (VATS), or with robotic techniques. CASE REPORT Here we report a case of a 53-year-old Saudi female patient who presented with dysphagia which had been ongoing for a long time. There were no other associated symptoms such as dyspepsia, nausea, or vomiting. She was diagnosed with a calcified leiomyoma of the esophagus based on a computed tomography (CT) scan and an endoscopic ultrasound (EUS) finding. After thorough investigations and workups, the management plan was taken at King Faisal Specialist Hospital and Research Centre by preforming a right video-assisted thoracoscopic enucleation. CONCLUSIONS The aim of this case report was to add to the literature by reporting the satisfactory outcomes of right video-assisted enucleation contrary to other surgical approaches that have been discussed in the literature.

Endometriosis of the Urinary Bladder Causing a Right Hydronephrosis: A Case Report.

BACKGROUND Endometriosis is a chronic and benign condition in which endometrial glands and stroma are present outside the uterine cavity. The pathogenesis of endometriosis is not fully understood; however, several mechanisms have been hypothesized. Endometriosis is a common clinical presentation in gynecology, but affecting the urinary tract is a rare phenomenon, occurring in 0.3-12% of cases. In more severe forms, the initial presentation may be hydronephrosis or infertility. CASE REPORT We describe the case of a 25-year-old Saudi woman who presented with obstructive urinary tract symptoms and was diagnosed with urinary bladder endometriosis complicated with a right hydronephrosis. After thorough investigations and workups, the management was taken on by a multidisciplinary team approach. CONCLUSIONS This case report shows that hormonal therapy management resulted in a satisfactory outcome contrary to the surgical resection approach that is discussed in many articles.