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1.
Int J Surg Case Rep ; 120: 109803, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38796939

RESUMO

INTRODUCTION AND IMPORTANCE: Cecal volvulus is a rare cause of obstruction in pregnancy. It accounts for ∼1.5 % of all intestinal obstructions. The diagnosis is challenging and causes increased morbidity and mortality to the mother and fetus. This case report will highlight the life-threatening nature of this condition and emphasize the critical importance of early diagnosis and intervention. CASE PRESENTATION: A 30-year-old gravida-3 para-2 patient presented with colicky abdominal pain of 24 h duration. She had associated abdominal distension, vomiting and fever. She had amenorrhea of 05-months. The past medical and surgical histories were negative. Her vital signs were deranged and had tenderness all over the abdomen. Ultrasound showed gaseous abdomen and viable fetus in the uterus. Laparotomy has revealed gangrenous cecal volvulus. A right hemicolectomy and end-to-side ileo-transverse colon anastomosis were performed. She expelled a dead fetus after 12 h. She was discharged in good clinical status. DISCUSSION: Cecal volvulus involves axial rotation of the ascending colon, cecum, and terminal ileum about associated mesentery. Pregnancy is among the pre-disposing factor for cecal volvulus. The diagnosis is often challenging because of non-specific presentations. Radiologic procedures are helpful in the diagnosis. The primary treatment is surgical intervention. CONCLUSION: Cecal volvulus is a rare life-threatening cause of obstruction in pregnancy. It is an emergency situation, and early diagnosis and intervention are crucial to decreasing morbidity and mortality. The most effective treatment is surgical resection.

2.
Int J Surg Case Rep ; 115: 109296, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38266365

RESUMO

INTRODUCTION AND IMPORTANCE: Hydatid disease is an infectious illness caused by a parasite called Echinococcus. It can affect any organ, primarily the liver and lungs. The occurrence of splenic or ovarian hydatid cyst is rare; simultaneous involvement of both is extremely uncommon. This case report provides valuable insights to clinicians, guiding them to consider a hydatid cyst as a potential differential diagnosis in the presence of a cystic mass lesion. CASE PRESENTATION: A 33-year-old female presented with abdominal pain of 10 years duration. The past medical and surgical history was negative. Ultrasound and CT scans of the abdomen showed double-layered splenic (15.3 cm × 12.8 cm × 15 cm) and pelvic (8.4 cm × 10.3 cm × 9 cm) cysts. Laparotomy revealed splenic and ovarian hydatid cysts with adhesions to surrounding structures. We performed total splenectomy and left salphingo-opherectomy, yielding excellent outcome. DISCUSSION: Hydatid cysts of the spleen and ovary are rare, with few case reports. It is usually secondary to systemic dissemination or intra-peritoneal spread from a ruptured hepatic cyst. Imaging modalities such as ultrasound and CT scans can aid in reaching a diagnosis. The standard treatment for a hydatid cyst is surgery. CONCLUSION: The simultaneous occurrence of hydatid cysts in the spleen and ovary is rare. The diagnosis is challenging due to nonspecific clinical presentations, necessitating a high level of suspicion. Surgery is the primary treatment for hydatid cysts.

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