RESUMO
Accessory breast tissue is an uncommon condition which occurs in 0.4-6% of women. It is mostly located in the axilla and has a high incidence of being misdiagnosed. Usually it is bilateral and presents as an asymptomatic mass during pregnancy or lactation. The diagnosis of ectopic breast tissue is important as it can undergo the same pathological changes that occur in a normal breast, such as mastitis, fibrocystic disease and carcinoma. We present a case of a bilateral axillary localization of accessory breast in a 45-year-old woman. The principal symptom was pain and the clinical diagnosis was bilateral lipoma. However, subsequent imaging and histopathological examination proved it to be an accessory breast tissue.
Assuntos
Axila/patologia , Doenças Mamárias/diagnóstico , Mama/anormalidades , Mama/patologia , Doenças Mamárias/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Gastroduodenal trichobezoar ulcer is rare. Its diagnosis is easy in the presence of an evocative context. We report the case of a 21-year old patient followed up for schizophrenia, admitted with acute abdominal pain, vomiting and epigastric mass. Abdominal CT scan suggested the diagnosis of bezoar on the basis of heterogeneous, non-enhanced lesions occupying the entire stomach and appearing to be separated from the gastric wall. Surgical removal of trichobezoar by gastrotomy was performed without complications. The patient was referred to the Department of Psychiatry.
Assuntos
Bezoares/diagnóstico por imagem , Duodeno/diagnóstico por imagem , Estômago/diagnóstico por imagem , Dor Abdominal/etiologia , Bezoares/cirurgia , Feminino , Gastrectomia/métodos , Humanos , Úlcera Péptica/diagnóstico , Tomografia Computadorizada por Raios X , Vômito/etiologia , Adulto JovemRESUMO
Bile ileus with migration of the gallstone into the colon through cholecystocolonic fistula is rare. The diagnosis is difficult and often late. We here report the case of a 89-year old patient with a history of sigmoid diverticular disease presenting with colonic obstruction associated with bile ileus caused by migration of a large gallstone through cholecystocolonic fistula. Abdominal CT scan allowed the diagnosis. The patient underwent surgical extraction of the gallstone with sigmoidotomy followed by sigmoidostomy with subsequent recovery of the digestive continuity. The cholecystocolonic fistula wasn't identified.
Assuntos
Cálculos Biliares/diagnóstico por imagem , Íleus/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Doenças do Colo Sigmoide/diagnóstico por imagem , Idoso de 80 Anos ou mais , Feminino , Cálculos Biliares/complicações , Cálculos Biliares/cirurgia , Humanos , Íleus/complicações , Fístula Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Doenças do Colo Sigmoide/etiologia , Doenças do Colo Sigmoide/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The cecum is the second part of the colon that is most commonly affected by the volvulus after sigmoid colon and before left corner and the transverse colon. This condition occurs in patients with abnormally mobile cecum. Volvulus is characterized by torsion or tilt. Clinically, it appears as bowel obstruction due to acute strangulation. Abdominal x-ray without treatment and abdominal CT scan are the radiological procedures of choice in the diagnosis of volvulus of the cecum. Treatment is based on emergency surgical excision of the cecum and of the terminal ileum. We report two cases of patients with volvulus of the cecum admitted to the emergency department with acute intestinal obstruction. In both patients, the diagnosis was confirmed by abdomino-pelvic CT scan and the treatment was based on ileocolic resection with immediate restoration of the intestinal continuity. The postoperative course was uneventful.
Assuntos
Doenças do Ceco/complicações , Obstrução Intestinal/etiologia , Volvo Intestinal/complicações , Idoso , Doenças do Ceco/diagnóstico , Doenças do Ceco/cirurgia , Ceco/patologia , Ceco/cirurgia , Humanos , Íleo/cirurgia , Volvo Intestinal/diagnóstico , Volvo Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Radiografia Abdominal , Tomografia Computadorizada por Raios XAssuntos
Equinococose/complicações , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Volvo Intestinal/etiologia , Mesentério/parasitologia , Doenças Peritoneais/complicações , Albendazol/uso terapêutico , Terapia Combinada , Equinococose/diagnóstico , Equinococose/tratamento farmacológico , Equinococose/cirurgia , Feminino , Humanos , Doenças do Íleo/cirurgia , Ileostomia , Obstrução Intestinal/cirurgia , Volvo Intestinal/cirurgia , Imageamento por Ressonância Magnética , Mesentério/cirurgia , Necrose , Doenças Peritoneais/diagnóstico , Doenças Peritoneais/tratamento farmacológico , Doenças Peritoneais/parasitologia , Doenças Peritoneais/cirurgia , Adulto JovemAssuntos
Antineoplásicos/uso terapêutico , Benzamidas/uso terapêutico , Tumores do Estroma Gastrointestinal/cirurgia , Piperazinas/uso terapêutico , Pirimidinas/uso terapêutico , Idoso , Terapia Combinada , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/patologia , Humanos , Mesilato de Imatinib , Intestino Delgado/patologia , Masculino , Resultado do TratamentoRESUMO
Benign cystic mesothelioma of the peritoneum (BCM) is an uncommon lesion with some 130 cases reported since the first case described by Smith and Mennenmeyer in 1979. It is a rare intra abdominal tumor occurring predominantly in women of reproductive age. Due to the rarity of this tumor, similarity of patient presentation, and comparable features on imaging, the diagnosis of this pathology is difficult, and is based on histological findings. This tumor is known for local recurrence. It's agreed that surgery is the only effective treatment, but there are no evidence-based treatment strategies for BCM.
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INTRODUCTION: A peritoneal simple mesothelial cyst is a very rare mesenteric cyst of mesothelial origin. The size of this lesion usually ranges between a few centimeters and 10 cm. It is usually asymptomatic, but occasionally presents with various, non-specific symptoms, which makes correct pre-operative diagnosis difficult. We present a case of a giant peritoneal simple mesothelial cyst that was successfully managed by complete surgical excision which is the treatment of choice. CASE PRESENTATION: A 21-year-old Caucasian Moroccan woman with vague abdominal discomfort and associated distention, during the previous 2 years, without other symptoms, presented to our hospital. Her past medical history was unremarkable. On physical examination, a mobile, painless and relatively hard abdominal mass was palpated. The laboratory examination and abdominal radiograph were unremarkable. Abdominal radiologic imaging showed a cystic mass of 35 × 20 × 10 cm that occupied the entire anterior and right abdominal cavity. Radical excision of the cyst was performed by midline laparotomy without any damage to the adjacent abdominal organs. The histopathological diagnosis was simple mesothelial cyst. The postoperative course was uneventful with no recurrence. CONCLUSION: A peritoneal simple mesothelial cyst is a quite rare abdominal tumor, that must always be considered in differential diagnosis of pelvic cystic lesions and other mesenteric cysts. The treatment of choice is the complete surgical excision of the cyst.
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INTRODUCTION: A solitary primary hydatid cyst in the subcutaneous abdominal wall is an exceptional entity, even in countries where the Echinococcus infestation is endemic. CASE PRESENTATION: We report a case of a 70-year-old Caucasian woman who presented to our hospital with a subcutaneous mass in the para-umbilical area with a non-specific clinical presentation. The diagnosis of subcutaneous hydatid cyst was suspected on the basis of radiological findings. A complete surgical resection of the mass was performed and the patient had an uneventful post-operative recovery. The histopathology confirmed the suspected diagnosis. CONCLUSION: Hydatid cyst should be considered in the differential diagnosis of every subcutaneous cystic mass, especially in regions where the disease is endemic. The best treatment is the total excision of the cyst with an intact wall.
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INTRODUCTION: Primary pancreatic hydatid cyst is extremely rare and may be a causative factor for obstructive jaundice. CASE PRESENTATION: A 27-year-old woman presented with obstructive jaundice, vomiting, pruritus, abdominal pain and an epigastric mass. A diagnosis of a pancreatic cyst causing a compression of the common bile buct was established by ultrasonography and CT scan before surgery. Hydatic serology was negative. The treatment consisted of the resection of the protruding dome with a drainage of the residual cavity and an omentoplasty. The recovery was uneventful and the patient has remained symptom free so far. CONCLUSION: The primary hydatid cyst of the pancreas may be a causative factor for obstructive jaundice and should be considered in the differential diagnosis of all cystic masses in the pancreas, especially in endemic areas.
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INTRODUCTION: Hematemesis caused by intragastric rupture of a splenic artery aneurysm, is an exceptional and potentially lethal emergency. CASE PRESENTATION: A 36 years old woman, mother of seven children presented with hematemesis. The gastric endoscopy revealed a bleeding polypoid lesion leading to a surgical management. The operative discovery of a complicated splenic artery aneurysm, led to its resection with splenectomy and gastric suture. CONCLUSION: Intragastric rupture of a splenic artery aneurysm is an exceptional emergency which urgent diagnosis and management can avoid a potential lethal evolution.