RESUMO
We present the case of a female patient in her 40s who underwent a splenic artery aneurysm (SAA) repair following a previous laparoscopic sleeve gastrectomy (SG). We aim to discuss the management approach to SAAs and considerations in the setting of previous bariatric surgery.The patient consented to this case report. We include preoperative and postoperative radiological images and intraoperative images.While pseudoaneurysms following bariatric surgery have been reported, we present a case of a likely true SAA following SG. Our experience may assist others who come across similar cases in the future.
Assuntos
Aneurisma , Gastroenteropatias , Laparoscopia , Obesidade Mórbida , Humanos , Feminino , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Artéria Esplênica/diagnóstico por imagem , Artéria Esplênica/cirurgia , Laparoscopia/métodos , Gastrectomia/métodos , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Aneurisma/cirurgiaRESUMO
Synchronous malignancies of the bile duct and the gallbladder are rare. These cases are often associated with pancreaticobiliary maljunction which is characterized by a long common shared pancreatobiliary channel leading to the Sphincter of Oddi. This predisposes the biliary epithelium to pancreatic enzyme reflux and makes the development of neoplasia more likely. We describe the case of a 64-year-old Caucasian female who presented with new jaundice and severe cholecystitis secondary to an impacted gallstone which was seen on ultrasound. Magnetic resonance cholangiopancreatography was organized with suspicion of a possible Mirizzi syndrome. This revealed a mid-distal bile duct cancer in addition to cholecystitis from an impacted gallstone. She was treated with intravenous antibiotics for her cholecystitis and underwent an urgent endoscopic retrograde cholangiopancreatography procedure for biliary decompression and stenting for her obstructive jaundice. The patient proceeded to pancreaticoduodenectomy with final histopathology revealing a synchronous primary gallbladder malignancy in addition to the known bile duct cancer.
Assuntos
Colecistectomia Laparoscópica/efeitos adversos , Veias Mesentéricas/patologia , Veia Porta/patologia , Trombose/etiologia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Diarreia/diagnóstico , Diarreia/etiologia , Hemorragia/diagnóstico , Humanos , Laparotomia/métodos , Masculino , Veias Mesentéricas/diagnóstico por imagem , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Reto/irrigação sanguínea , Reto/patologia , Trombose/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia Doppler Dupla/métodosAssuntos
Rim Fundido/complicações , Hérnia Inguinal/diagnóstico , Escroto , Doenças Ureterais/diagnóstico , Idoso , Diagnóstico Diferencial , Rim Fundido/diagnóstico , Hérnia Inguinal/complicações , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Humanos , Laparoscopia , Masculino , Tomografia Computadorizada por Raios X , Doenças Ureterais/complicações , Doenças Ureterais/cirurgia , UrografiaAssuntos
Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/patologia , Neoplasias Esofágicas/etiologia , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas do Esôfago/etiologia , Carcinoma de Células Escamosas do Esôfago/terapia , Humanos , Lesões Pré-Cancerosas/etiologia , Lesões Pré-Cancerosas/patologiaRESUMO
A 77-year-old man presented with watery, bloody diarrhoea, symptomatic anaemia and signs of sepsis. He was well known to our unit with a history of extensive low-grade urothelial carcinoma involving a solitary kidney. CT performed on admission demonstrated a new finding of renocolic fistula. Due to his multiple medical and surgical comorbidities conservative management was elected. He passed away after 1 year of follow-up.