RESUMO
INTRODUCTION: Retrocecal hernia is a rare type of pericecal hernia. Because it is difficult to diagnose preoperatively, it is often treated with emergency operation. CASE PRESENTATION: An 83-year-old male patient experienced sudden abdominal pain. Marked small bowel dilatation and intestinal obstruction were detected by abdominal computed tomography (CT). An enhanced CT scan also revealed a trapped cluster of small bowel loops behind the cecum and ascending colon. We preoperatively diagnosed small bowel ileus as a result of retrocecal hernia. After conservative therapy with a long intestinal tube, an emergency operation was performed. During the surgery, a portion of the ileum was found to be incarcerated in the retrocecal fossa. Intestinal resection was not necessary because the incarcerated ileum appeared viable, and the orifice to the hernia was opened. The patient was discharged without postoperative complications. DISCUSSION: The diagnosis of retrocecal hernia can often be confirmed intraoperatively. This disease is identified based on a minimal error in rotation with incarceration behind the cecum during the final phase of descent and fixation of the right colon or failure of cecal and retroperitoneal fixation. Early preoperative diagnosis is important to prevent intestinal ischemia, necrosis, and perforation and to reduce resection rates. CONCLUSION: Early preoperative diagnosis is important to avoid resection of the small intestine. CT scans are useful for preoperative diagnosis in case of retrocecal hernia.
RESUMO
INTRODUCTION: An accessory liver lobe is a rare developmental abnormality, which is often not diagnosed preoperatively, and is usually detected incidentally during abdominal surgery. This condition is often asymptomatic; here, we report on a case where the accessory liver lobe was diagnosed preoperatively using ultrasonography. CASE PRESENTATION: A 59-year-old woman presented to our hospital with right upper abdominal pain. An abdominal ultrasonography indicated the presence of gallbladder debris and an accessory liver lobe. She underwent laparoscopic cholecystectomy and resection of the accessory liver lobe without any complications. DISCUSSION: An accessory liver lobe is a rare anomaly of the liver. It is typically asymptomatic and is detected incidentally during surgery or autopsy in most cases. However, we diagnosed the accessory liver lobe using ultrasonography. An accessory liver lobe can occasionally result in complications, such as bleeding, portal vein obstruction, or malignant transformation to hepatocellular carcinoma. CONCLUSION: An accessory liver lobe should be resected to prevent complications and malignant transformation. Ultrasonography is useful for preoperative diagnosis in cases with an accessory liver lobe.
