RESUMO
We report two cases of the rare complication of a colonoscope incarcerated in an inguinal hernia. The first patient was a 73-year-old man in whom a colonoscope was incarcerated in a left inguinal hernia on attempted withdrawal. The incarcerated colonoscope was successfully reduced manually under fluoroscopic guidance. The hernia was subsequently repaired using an extraperitoneal approach followed by a successful colonoscopy. The second patient was a 74-year-old man in whom the colonoscope became incarcerated in a left inguinal hernia on insertion. Similar to the first case, the colonoscope was manually reduced under fluoroscopy and the entire colonoscopy was then uneventfully performed. An advanced sigmoid cancer was identified and treated with sigmoidectomy. The hernia resolved after this operation. When a colonoscope becomes incarcerated in an inguinal hernia, the manual reduction should be attempted. Subsequent colonoscopy can be safely performed under certain circumstances.
RESUMO
A 53-year-old woman was referred to our hospital with a 40-mm splenic tumor, which was detected incidentally on abdominal computed tomography during hospitalization for pyelonephritis. The tumor was hypointense on T2-weighted imaging and gradually enhanced on dynamic study. The tumor increased in size over a six-month period. Since we could not exclude splenic malignancy, we performed laparoscopic partial splenectomy. Histological examination revealed multiple angiomatoid nodules with three distinct vessel types. Pathologically, the tumor was diagnosed as a sclerosing angiomatoid nodular transformation (SANT). We then examined the correlation between the imaging and pathological findings, and performed a review of previous reports, concluding that contrast-enhanced MRI was the most useful modality for diagnosing SANT.
Assuntos
Esplenopatias/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Imagem Multimodal , Esplenectomia , Esplenopatias/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , UltrassonografiaRESUMO
A 56-year-old woman was admitted to our hospital with fever and systemic malaise. Abdominal computed tomography revealed an enhanced tumor of the pancreatic head, measuring 9cm in maximal diameter and containing a low-density area. Subtotal stomach-preserving pancreatoduodenectomy was performed. Hemorrhage and necrosis were evident within the tumor, and osteoclastic polynuclear giant cells were also identified. A diagnosis of giant cell anaplastic ductal carcinoma of the pancreas was made. The patient has been free from recurrence for 6 months since surgery.
