Torsion of suprahepatic gall bladder.

Suprahepatic gall bladder is rare, and torsion of the ectopic gall bladder is extremely rare. We report a patient of acute suprahepatic cholecystitis with torsion. A 69-year-old Korean male was admitted to our hospital for sudden-onset, severe epigastric pain. Abdominal computed tomography and ultrasonography showed a distended gall bladder with diffuse wall thickening and scanty pericholecystic fluid, which was located in ectopic suprahepatic position, accompanied by S4 hypotrophy of the liver without gallstones. Emergency laparoscopic cholecystectomy was performed, and intraoperative findings revealed a distended and ischaemic gall bladder that was located in the suprahepatic position and had twisted along the cystic duct and artery pedicle in a clockwise manner. Detorsion was done and the gall bladder was resected. Unfortunately, the pre-operative diagnosis of gall bladder torsion was missed, and a definite diagnosis was made at the time of surgery. The patient was discharged on the 4th post-operative day.

Laparoscopic transabdominal extraperitoneal mesh repair of lumbar hernia.

Lumbar hernias are rare posterolateral abdominal wall defects that may be congenital or acquired. There are two types of lumbar hernia, the superior lumbar hernia through Grynfeltt triangle, and the inferior lumbar hernia through Petit triangle. Many techniques have been described for the surgical repair of lumbar hernias including primary repair, local tissue flaps, and conventional mesh repair. But these open techniques require a large skin incision. We report a case of superior lumbar hernia, which was successfully repaired using a laparoscopic approach.