Intermittent melena and refractory anemia due to jejunal cavernous lymphangioma: A case report.

BACKGROUND: Lymphangiomas in the gastrointestinal tract are extremely rare in adults. As a benign lesion, small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis. However, lymphangiomas can give rise to complications such as abdominal pain, bleeding, volvulus, and intussusception. Here, we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult. CASE SUMMARY: A 66-year-old man presented with intermittent melena, fatigue and refractory anemia nine months prior. Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding. Conservative management, including transfusion, hemostasis, gastric acid secretion inhibition and symptomatic treatment, was performed, but the lesions tended to recur shortly after surgery. Ultimately, the patient underwent capsule endoscopy, which revealed a more than 10 cm lesion accompanied by active bleeding. After single-balloon enteroscopy and biopsy, a diagnosis of jejunal cavernous lymphangioma was confirmed, and the patient underwent surgical resection. No complications or recurrences were observed postoperatively. CONCLUSION: Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding. Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis. Surgical resection is an effective management method.

Concomitant non-Hodgkin's lymphoma in colon and liver: report of a rare case and review of literature.

A 58-year-old male patient was admitted with right upper abdominal pain. Initial hematologic evaluation revealed mildly elevated serum carcinoembryonic antigen and carbohydrate antigen (CA) 19-9 tests, while an abdominal CT-scan showed a circumferential mass along the distal ascending colon and the right flexure of colon, simultaneously a liver lesion in segment 8 is considered metastases from colorectal. colonoscopic examination revealed a circumferential growth tumor in the right flexure of colon and the colonoscopy can not reach the proximal of the tumor. We performed a right hemihepatoectomy and a right hemicolectomy associated with loco-regional lymphadenectomy. Histological examination showed diffuse large B-cell lymphomas in resected right colon as well as liver tumors. The patient received six courses of chemotherapy with CHOP-based regimens. At 14-month follow-up before this report, the patient is still alive and free of disease.

[The mechanism and clinical applied skills of "curettage and aspiration" technique].

OBJECTIVE: To investigate the mechanism of "curettage and aspiration" and to conclude its applied technique. METHODS: 2213 complicated abdominal cases, which operation were performed with the PMOD and its "curettage and aspiration" technique from November 1997 to May 2006, were analyzed retrospectively. Meanwhile, the successful rate of operations, the duration of operation, the blood loss of operation and the postoperative complications were statistically analyzed. RESULTS: Each operation was successfully accomplished without damage of the big blood vessels and the biliary tracts. The mean blood loss of pancreatoduodenectomy and radical gastrectomy for cancer, were respectively 105 ml and 75 ml, the mean duration was respectively 3.6 hours and 2.3 hours. As to the acute cholecystitis, the resectable rafe of gallbladder was 100%. Furthermore, no case needs blood transfusion, no massive hemorrhage and concerned damage happened when performing the operation for retroperitoneal tumor. CONCLUSION: With reasonable operational principles and applied techniques, PMOD (Peng's multifunctional operativedissector) and "curettage and aspiration" technique have demonstrated its specific superiorities in the complicated abdominal operations.