Occasional finding of mesenteric lipodystrophy during laparoscopy: a difficult diagnosis.

Mesenteric lipodystrophy is a rare pathological condition affecting the mesentery. Its initial presentation is typically asymptomatic. Pathological characteristics are unspecific, and generally attributed to inflammation, unless the diagnosis is suspected. Laparoscopy done for other reasons has been, as in this case, unsuccessful in providing evidence for the correct diagnosis, thus requiring laparotomy due to lack of diagnostic tissue. After 6 mo no further medical therapy is required, as the patient remains asymptomatic. Discussion of this case and a brief review of the literature are presented in the following paragraphs.

Comparison between laparoscopic and open repair for perforated peptic ulcer. A retrospective study.

The aim of the study was to assess the differences in postoperative outcome in two well-matched groups of patients undergoing suture of a perforated peptic ulcer. The first 10 patients were treated laparoscopically, and the second group of 10 in a traditional manner through a midline xipho-umbilical incision. Operative technique was the same, only via a different access. Variables influencing outcome were matched for comparison of the influence of the technique. All patients underwent operation within 24 hours from onset of symptoms. Analysis of pre-, intra- and postoperative factors was done for the two groups. A significant difference was found only in the percentage of wound infections (0% vs 40%) in favour of the laparoscopic group. Surgical time, postoperative pain, resumption of feeding and discharge from hospital were similar in the two groups. As in other larger studies, our findings confirm the indication for laparoscopy in acute abdomen. The suture technique is feasible and safe and is to be considered as the gold standard when used with the same indications as in open surgery.