[Neuroendocrine small-cell carcinoma of the gallbladder. An unexpected finding after diagnostic laparoscopy]. / Carcinoma neuroendocrino de células pequeñas de vesícula biliar. Un hallazgo inesperado con el uso de laparoscopia diagnóstica.

BACKGROUND: Gallbladder cancer ranks fifth among oncological diseases affecting the gastrointestinal tract; nevertheless, it is the world's most common malignant tumor of the bile ducts. It is usually diagnosed after cholecystectomy and tends to have bad prognosis. Adenocarcinoma is the main histological finding, although other rare histologic types have been described among the actual literature. Poorly differentiated squamous-cell neuroendocrine gallbladder carcinoma is an extremely rare neoplasm. A poor prognosis is associated with this histological type. AIM: The aim of this paper is to show that performing a systematic exploration of the entire peritoneal cavity in all laparoscopic surgeries can lead to find completely unexpected changes related to an unidentified disease. Also, a detailed review of our unexpected finding is made: The neuroendocrine small cell carcinoma of gallbladder. CLINICAL CASE: We hereby report the case of a 40-year-old patient with a ruptured ectopic pregnancy that underwent emergency laparoscopic surgery, presenting the incidental finding of a small-cell carcinoma of the gallbladder. CONCLUSIONS: Our surgical group advised that by introducing the laparoscope, the entire peritoneal cavity must be systematically reviewed, in search of differential diagnoses and unidentified pathologies. We must use the diagnostic and therapeutic qualities of laparoscopy. Bile duct endocrine tumors tend to remain silent until advanced stages, making the prognosis usually unfavorable, especially when they are unresectable. Endocrine neoplasias of the gallbladder, although uncommon, should be taken into account as possible diagnoses due to its therapeutic and prognostic implications.

[Small bowel obstruction secondary to incomplete torsion of proximal ileum following laparoscopic hysterectomy. Case report]. / Oclusión intestinal por torsión incompleta de íleon proximal post histerectomía laparoscópica. Un caso clínico.

A minimally invasive approach for gynecologic procedures has become popular in recent years. Despite the advantages of this kind of surgery over open technique, laparoscopic hysterectomy is not free of complications. A case of small bowel obstruction secondary to incomplete torsion of proximal ileum ten days after an uneventful total laparoscopic hysterectomy is reported. Partial small bowel obstruction (PSBO) is a rare complication after gynecologic laparoscopy; its post-operatory incidence is 0.036% within a month after. A clean, adequate surgical technique, with minimal manipulation of internal organs, reduces the risk of adhesive process and PSBO.