RESUMO
A 20-year old woman with a 2-month history of epigastric pain, progressive jaundice and obstructive liver biochemistry underwent imaging of the biliary tract, carried out using ultrasonography, CT-scan and MRI. Abdominal ultrasound showed a dilation of the choledochal duct. CT-scan and MRI revealed a cystic dilation of the choledochal duct. Because of possible malignant degeneration, en-bloc cholecystectomy and resection of the cyst were performed, with Roux-en-Y hepaticojejunostomy reconstruction. This case demonstrates the diagnostic value of MRI and MRCP in a pathology that is rather rare in Western countries.
Assuntos
Colangiopancreatografia por Ressonância Magnética , Cisto do Colédoco/cirurgia , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Adulto , Anastomose em-Y de Roux , Colecistectomia , Cisto do Colédoco/diagnóstico , Feminino , Humanos , Jejunostomia , Testes de Função HepáticaRESUMO
Intussusception is rare in adults and it can be a challenge to diagnose on admission. Non-specific and variable signs and symptoms, frequently only occurring episodically, may cause a considerable delay before treatment. However, in 90% a predisposing organic cause can be found in adults. A case is presented of small bowel intussusception secondary to a lipoma in a 54-year-old man in whom diagnosis was suggested by CT-scan. The patient was treated with a laparoscopic-assisted reduction and extracorporeal partial small bowel resection, followed by a latero-lateral anastomosis. This case serves as the basis of a review of small bowel intussusception in adults secondary to lipomas. It focuses on the rarity of the disease, but stresses the need for early referral and investigation in middle-aged patients with recurrent abdominal symptoms.
Assuntos
Doenças do Íleo/etiologia , Neoplasias Intestinais/diagnóstico , Intussuscepção/etiologia , Lipoma/diagnóstico , Humanos , Doenças do Íleo/cirurgia , Neoplasias Intestinais/cirurgia , Intestino Delgado/patologia , Intestino Delgado/cirurgia , Intussuscepção/cirurgia , Lipoma/cirurgia , Masculino , Pessoa de Meia-IdadeRESUMO
Endometriosis has been observed in 8 to 15% of the women of reproductive age. Occasionally it can be found outside the pelvis, its usual location. Rather exceptionally it is located on the diaphragm. A case report of preoperatively diagnosed bilateral diaphragmatic endometriosis is presented and its surgical treatment will be discussed.
Assuntos
Diafragma/cirurgia , Endometriose/cirurgia , Doenças Musculares/cirurgia , Adulto , Endometriose/diagnóstico , Feminino , Humanos , Imageamento por Ressonância Magnética , Doenças Musculares/diagnóstico , Procedimentos Cirúrgicos Operatórios/métodosRESUMO
Needle catheter jejunostomy is a technique to allow enteral feeding after upper abdominal surgery. An unusual postoperative complication is pneumatosis intestinalis which can be life-threatening. A case of a 76-year-old man with pneumatosis intestinalis due to needle catheter jejunostomy, in whom diagnosis was made by CT-scan, is described. Needle catheter jejunostomy complicated by pneumatosis intestinalis needs attention and careful treatment. Removal of the catheter seems necessary, although controversy remains.
