Giant peritoneal loose body : a case report and review of the literature.

We present a case about a 53-year-old man who complained of abdominal pain and constipation. Computed tomography showed a well-described nodular structure of 6cm in size with a central dense core of 0.5cm with compression against the rectosigmoid. The presence of a foreign body was suggested and a diagnostic laparoscopy was performed. Surgery revealed a giant peritoneal loose body measuring 5.5cm in diameter. After the removal, the patient was relieved of his symptoms. Peritoneal loose bodies are usually small and asymptomatic. They are mostly found incidentally during laparotomy. Giant peritoneal loose bodies are a rare entity and diagnosis is difficult. A review of the literature is presented.

Surgery for gastric remnant carcinoma following Billroth II gastrectomy.

Between January 1983 and December 1995, 31 patients with gastric remnant carcinoma were operated on 6-45 years after a Billroth II resection for peptic ulcer disease. Total gastrectomy with Roux-en-Y reconstruction was performed in all cases. In 16 patients (52%) extended resection with removal of one or more adjacent organs was necessary for oncological reasons. In this elderly population with a high incidence of pre-operative risk factors (55%), most tumours were classified as stage III or IV (45%). Although total gastrectomy should be the surgical option of first choice for gastric remnant carcinoma, it resulted in high levels of post-operative mortality and morbidity (13% and 35%, respectively), especially in patients with stage III and IV tumours who underwent resection of an adjacent organ. Despite extended surgery, if necessary, the recurrence rate after 'curative' surgery is high (8/20 patients) and the cumulative disease-free 5-year survival rate was 48%. Detection of the tumour at an earlier stage not only limits the extent of resection and lowers the complication rate, but also improves survival.

Laparoscopic rectopexy: early results.

Five patients with complete rectal prolapse were operated by laparoscopic approach. Technical details are described. Preliminary results are excellent.

Lost gallstones: a relaparoscopic solution to laparoscopic pollution.

This case report describes the treatment by radiological intervention combined with therapeutic relaparoscopy of a patient with a gluteolumbar fistula due to lost gallstones 5 years after laparoscopic cholecystectomy.

Primary pure squamous cell carcinoma of the antrum of the stomach: a case report.

A case of a patient with a pure squamous cell carcinoma of the stomach is presented. Surgery, the treatment of choice for this rare gastroenterological tumour, gives no guarantee for cure. Prognosis, as is demonstrated by our case, is poor with few exceptions. Different theories of histopathogenesis are discussed in the literature but no definitive statement can be made.

Papillary cystadenoma of the epididymis: a case report.

In this report a case of bilateral papillary cystadenoma of the epididymis is described, a tumor associated with the Von Hippel-Lindau's disease (cerebelloretinal hemangioblastomatosis). Reports about the Von Hippel-Lindau's disease do only infrequently mention epididymal adenomas because the latter is mostly not associated with any symptoms. Retinal angiomatosis, cerebellar hemagioblastoma, pheochromocytoma and renal cell carcinoma are the lesions in the Von Hippel-Lindau's disease which cause symptoms and as a consequence disease. Because of some histological similarities between papillary cystadenoma and the clear cell type of renal adenocarcinoma a metastasis of a renal cell carcinoma has to be added to the list of differential diagnosis in case of an epididymal benign tumor apart from adenomatoid tumor, fibroma, lipoma,... The epididymal papillary cystadenoma, which is the only known benign epididymal tumor of epithelial origin, is considered a hereditary hamartoma. The precise histogenetic origin is still controversial.