RESUMO
Peritoneal tuberculosis is a rare form of tuberculosis which gives a non-specific clinical picture which can be confused with several digestive pathologies. It can also mimic ovarian cancer at the stage of peritoneal carcinomatosis, hence the interest sometimes of a diagnostic laparoscopy which makes it possible to make the diagnosis which is confirmed by an anatomo-pathological study. This is the case of our patient who was initially diagnosed with ovarian cancer and the diagnosis was corrected in peritoneal tuberculosis after a laparoscopy.
Assuntos
Laparoscopia , Neoplasias Ovarianas , Neoplasias Peritoneais , Peritonite Tuberculosa , Humanos , Feminino , Neoplasias Peritoneais/diagnóstico , Diagnóstico Diferencial , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/patologia , Peritonite Tuberculosa/diagnósticoRESUMO
Total small bowel volvulus complicating common incomplete mesentery is an arrest of rotation of the primary intestinal loop at 180°. The root of the mesentery is very short and the whole small intestine is located on the superior mesenteric artery axis. Patients are at very high risk of small bowel volvulus and enteromesenteric infarction. Acute volvulus requires emergency surgery; imaging must not delay surgery. Surgery is based on the untwisting of the volvulus (counterclockwise) after the assessment of intestinal viability. The intestine placed in the complete common mesentery position: the cÅcum is situated in the right iliac region. We report the case of a 60-year old patient admitted with total small bowel volvulus on an incomplete common mesentery who underwent emergency surgery with favorable postoperative outcome.
Assuntos
Volvo Intestinal/diagnóstico , Intestino Delgado/patologia , Mesentério/anormalidades , Humanos , Volvo Intestinal/patologia , Volvo Intestinal/cirurgia , Intestino Delgado/cirurgia , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoAssuntos
Apendicectomia/métodos , Apendicite/cirurgia , Apêndice/anormalidades , Adulto , Apêndice/patologia , Apêndice/cirurgia , Humanos , Masculino , RecidivaAssuntos
Carcinoma Neuroendócrino , Neoplasias Pancreáticas , Ampola Hepatopancreática/diagnóstico por imagem , Carcinoma Neuroendócrino/complicações , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/cirurgia , Colestase Extra-Hepática/etiologia , Neoplasias do Ducto Colédoco/complicações , Neoplasias do Ducto Colédoco/diagnóstico por imagem , Neoplasias do Ducto Colédoco/cirurgia , Diabetes Mellitus Tipo 2/complicações , Endossonografia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia , Tomografia Computadorizada por Raios XRESUMO
Fournier's Gangrene is a rare complication of rectal cancer. Its discovery is often delayed. It's incidence is about 0.3/100,000 populations in Western countries. We report a patient with peritoneal perforation of rectal cancer revealed by scrotal and perineal necrotizing fasciitis.
Assuntos
Adenocarcinoma/complicações , Gangrena de Fournier/etiologia , Neoplasias Retais/complicações , Antibacterianos/uso terapêutico , Colectomia , Colo Sigmoide/cirurgia , Desbridamento , Diagnóstico Precoce , Emergências , Gangrena de Fournier/diagnóstico , Gangrena de Fournier/tratamento farmacológico , Gangrena de Fournier/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Períneo/patologia , Escroto/patologiaAssuntos
Neoplasias Hepáticas/diagnóstico por imagem , Mesentério/diagnóstico por imagem , Tumores Neuroectodérmicos Primitivos/diagnóstico por imagem , Neoplasias Peritoneais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Biópsia , Meios de Contraste , Feminino , Humanos , Neoplasias Hepáticas/patologia , Invasividade Neoplásica , Tumores Neuroectodérmicos Primitivos/patologia , Neoplasias Peritoneais/patologia , Recusa do Paciente ao TratamentoAssuntos
Obstrução Duodenal/cirurgia , Intussuscepção/etiologia , Jejunostomia/efeitos adversos , Doença Aguda , Obstrução Duodenal/etiologia , Úlcera Duodenal/complicações , Humanos , Intussuscepção/diagnóstico , Intussuscepção/cirurgia , Jejunostomia/instrumentação , Masculino , Pessoa de Meia-Idade , Reoperação , Resultado do TratamentoRESUMO
Paraduodenal hernia is a rare congenital anomaly that arises from an error of rotation of the midgut. The duodenum and the small intestine become trapped in a sac which is lined by the peritoneum, behind the mesentery of the colon, either to the right or left of the midline. It is therfore a rare and potentially life-threatening condition that can cause intestinal obstruction progressing to strangulation and perforation. We report a case of a 55-year-old patient presenting a left paraduodenal hernia diagnosed intraoperatively after being operated on in the emergency setting for acute abdomen. The small bowel was twisted upon its mesentery and was entrapped in a large left paraduodenal space. Fortunately, once the bowel was reduced from the paraduodenal space, the blood flow was reestablished and the small bowel resumed a proper functioning. The mouth of the sac was obliterated by suture opposition to the posterior wall. The patient's subsequent hospital course was uneventful, and he was discharged in satisfactory condition 4 days postoperatively.
Assuntos
Abdome Agudo/etiologia , Duodenopatias/complicações , Hérnia/complicações , Abdome Agudo/diagnóstico , Abdome Agudo/cirurgia , Duodenopatias/diagnóstico , Duodenopatias/cirurgia , Hérnia/diagnóstico , Herniorrafia , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-IdadeRESUMO
Gastrointestinal stromal tumors (GISTs) represent the majority of primary non-epithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by immunohistochemical staining for the CD117 antigen. Extragastrointestinal stromal tumors (EGISTs), neoplasms with immunohistological features overlapping those of GISTs, are found in the abdomen outside of the gastrointestinal tract with no connection to the gastric or intestinal wall. We report the clinical, macroscopic and immunohistological features of an EGIST arising in the lesser omentum of a 58-year-old woman. This is a very rare location of intra abdominal stromal tumors.
Assuntos
Tumores do Estroma Gastrointestinal/patologia , Omento/patologia , Proteínas Proto-Oncogênicas c-kit/análise , Feminino , Tumores do Estroma Gastrointestinal/diagnóstico , Humanos , Pessoa de Meia-IdadeRESUMO
Intestinal obstruction is common surgical emergency; ileosigmoid knot is a rare cause of intestinal obstruction (a loop ileum and sigmoid colon twisted around each other in a knot). We recorded a three cases in HASSAN II hospital in the last 3 years.
Assuntos
Doenças do Íleo/patologia , Obstrução Intestinal/etiologia , Doenças do Colo Sigmoide/patologia , Adulto , Idoso , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/cirurgia , Obstrução Intestinal/cirurgia , Volvo Intestinal/diagnóstico , Volvo Intestinal/patologia , Volvo Intestinal/cirurgia , Pessoa de Meia-Idade , Doenças do Colo Sigmoide/diagnóstico , Doenças do Colo Sigmoide/cirurgiaAssuntos
Adenocarcinoma/patologia , Neoplasias Intestinais/patologia , Neoplasias Vaginais/patologia , Adenocarcinoma/secundário , Adenocarcinoma/terapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Mucosa Intestinal/patologia , Neoplasias Intestinais/terapia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Vaginais/secundário , Neoplasias Vaginais/terapiaAssuntos
Canal Anal/cirurgia , Incontinência Fecal/cirurgia , Canal Anal/lesões , Parto Obstétrico/efeitos adversos , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Terapia por Estimulação Elétrica , Incontinência Fecal/diagnóstico , Incontinência Fecal/diagnóstico por imagem , Incontinência Fecal/epidemiologia , Feminino , Humanos , Masculino , Manometria , Músculo Liso/cirurgia , Prevalência , Prognóstico , Próteses e Implantes , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Raízes Nervosas Espinhais , Técnicas de Sutura , Resultado do Tratamento , UltrassonografiaAssuntos
Neoplasias da Mama Masculina/diagnóstico , Adenocarcinoma Mucinoso/patologia , Idoso , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/patologia , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/patologia , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Neoplasias Hormônio-Dependentes/diagnóstico , Neoplasias Hormônio-Dependentes/epidemiologia , Neoplasias Hormônio-Dependentes/patologia , Estudos RetrospectivosRESUMO
Intussusceptions in adults is rare. Gastrointestinal lipomas are rare benign tumors and intussusceptions due to a gastrointestinal lipoma constitutes an infrequent clinical entity. Lipoma may develop as a benign tumor in all organs and rarely in large or small intestine. The present report describes a case of jejunojejunal intussusceptions in an adult with a history of colicky upper abdominal pain. Ileo-ileal invagination was diagnosed by computed tomography scan. Exploratory laparotomy revealed jejunojejunal intussusceptions secondary to a lipoma which was successfully treated with segmental intestinal resection. A review of the literature is also performed regarding this rare association revealing the diagnostic and therapeutic debates that exist. ABSTRACT (FRENCH): L'invagination chez les adultes est rare. Les lipomes gastro-intestinaux sont de rares tumeurs bénignes et l'invagination intestinale due à un lipome gastro-intestinal constitue une entité clinique trés rare. Le lipome peut se développer comme une tumeur bénigne dans tous les organes et rarement dans l'intestin grêle ou le colon. Le présent rapport décrit un cas d'invagination jéjunojéjunale chez un adulte avec une histoire de douleurs abdominales. Iléo-iléale invagination a été diagnostiquée par tomodensitométrie. Une laparotomie exploratrice a révélé l'existence d'une invagination jéjunojéjunale secondaire à un lipome qui a été traitée avec succès par une résection intestinale segmentaire. Une revue de la littérature est également effectuée au sujet de cette association rare révélant les débats diagnostiques et thérapeutiques qui existent.
RESUMO
INTRODUCTION: Appendiceal intussusception is a very rare disease that is found in only 0.01% of patients who have undergone an appendectomy. Clinical symptoms vary and some patients are asymptomatic. Laparoscopic surgery for appendiceal tumors is still controversial. We present a case of intussusception of the appendix with a mucinous cystadenoma treated by laparoscopic surgery. PRESENTATION OF CASE: We report a case of 47 year-old-women patient who presented with a six month history of intermittent right lower abdominal pain. Abdominal computer tomography CT showed appendiceal mass with intussusception. A laparoscopic right hemicolectomy was performed because the tumor involved the entire appendix. Histopathological examination revealed mucocele due to mucinous cystadenoma of appendix. DISCUSSION: Appendiceal intussusception to the cecum caused by mucocele of the appendix is extremely rare. It is very difficult to diagnose the presence of an intussuscepted appendix pre-operatively and investigations will usually include colonoscopy and CT scan. An appendicular intussusception should not be reduced by colonoscopy. Laparoscopic surgery for appendiceal tumors is still controversial; the main concerns to be addressed are the adequacy of resection and intraperitoneal rupture of the tumor. Our patient successfully underwent laparoscopic surgery without any complications. CONCLUSION: Appendiceal intussusception to the cecum caused by mucocele of the appendix is a rare cause of abdominal pain and difficult to diagnose. The laparoscopic surgery for appendiceal tumors is safe, feasible, and even may be beneficial.
RESUMO
Desmoid tumors most often occur in abdominal wall. Their tendency to recur lead to repeated operations which can make the abdominal wall reconstruction difficult. We report a 28-year-old female history. The patient was referred to our hospital for a recurrent desmoid tumor of the abdominal wall. The tumor was totally removed. The reconstruction was successful and the patient recovery was uneventful. Radical surgery still the mainstay of the desmoid tumors treatement. In abdominal wall location, the reconstruction can be a real challenge. Many procedures are discussed in literature. We used a double layer mesh covered by a fascial bepedicled flap. Taking into account their unpredictable behaviour and treatment complications, recurrent abdominal desmoid tumors can be managed simply and efficiently.