RESUMO
Duplication cysts of gastrointestinal tract are rare congenital abnormalities found in 0.2% of children. We report a rare case of a ruptured duplication cyst of transverse colon in a 7-year-old female child who presented with abdominal pain and mass in the right iliac fossa. We assumed it as an appendicular mass; however, it turned out to be a ruptured duplication cyst of transverse colon. Only two cases of duplication cyst of transverse colon have been reported yet in the literature.
Assuntos
Colo Transverso/anormalidades , Cistos/congênito , Cistos/patologia , Apêndice , Criança , Cistos/cirurgia , Feminino , Humanos , Ruptura EspontâneaRESUMO
Gastrointestinal duplications are extremely rare congenital abnormalities having definite difficulties to be diagnosed preoperatively. Most of them are presented at the oesophagus and ileum and only involve colon from 4% to 18%. We illustrate a case report of an 18-year-old female patient with transverse colon duplication. There were symptom manifestations such as chronic constipation with flatulence accompanied with abdominal pain. We demonstrate this case report due to non-specific clinical presentation and some difficulties to form preoperative diagnosis. The patient underwent surgery. Tubular transverse colon duplication communicated with normal bowel in the proximal part was revealed. We performed transverse colon resection with duplication. The postoperative period was uneventful.
Assuntos
Dor Abdominal/etiologia , Colectomia/métodos , Colo Transverso/anormalidades , Constipação Intestinal/etiologia , Dor Abdominal/cirurgia , Adolescente , Doença Crônica , Colo Transverso/fisiopatologia , Colo Transverso/cirurgia , Constipação Intestinal/diagnóstico , Constipação Intestinal/fisiopatologia , Constipação Intestinal/cirurgia , Feminino , Flatulência/etiologia , Humanos , Resultado do TratamentoRESUMO
A Bochdalek hernia (BH) occurs when abdominal contents herniate through the postero-lateral segment of the diaphragm. The right side is affected considerably less commonly than the left. Most BHs present are diagnosed early in life, with some element of cardio-respiratory distress. Rarely, hernias that remain clinically silent until adulthood when they present as life-threatening surgical emergencies. We report a case 35 year old female who emergency exploratory laparotomy for a complete mechanical bowel obstruction. At surgery the redundant transverse colon was twisted and incarcerated within the right hemithorax, creating a closed loop obstruction. The right colon, appendix, terminal ilium, and three accessories right liver lobes were also dragged into the right thoracic cavity. After reducing the hernia, the diaphragmatic defect was primarily repaired with non-absorbable suture. The redundant transvers colon which had been compromised was resected and primary end-to- end anastomosis was carried out. Incidental appendectomy was done. The patient was sent into ICU for post-operative monitoring. She made an uneventful recovery and remains asymptomatic at nine month follow-up. I discuss what i believe to be the first case report of complicated right diaphragmatic hernia in Botswana, associated with another congenital mal-formation (accessories hepatic lobes, partial mal-rotation, and redundant transvers colon) in adult.
Assuntos
Hérnias Diafragmáticas Congênitas/diagnóstico , Obstrução Intestinal/etiologia , Fígado/anormalidades , Adulto , Apendicectomia/métodos , Botsuana , Colo Transverso/anormalidades , Feminino , Seguimentos , Hérnias Diafragmáticas Congênitas/complicações , Humanos , Obstrução Intestinal/cirurgia , Laparotomia/métodosRESUMO
Gatrointestinal duplications are rare congenital anomalies, usually detected prenatally or in the first two years of life, although they can be diagnosed even in older age. Within the abdomen, a small bowel location is the most frequent (more than 50% of cases), while colonic site accounts for 17% of patients; transverse colonic location is very rare. These lesions can vary in shape, being cystic or tubular, and typically show the same structure of the adjacent normal bowel, with which they can have direct communication. The most of case of intestinal duplication in adults present with acute abdomen and bowel obstruction, and are more common in the ileum than in the colon. When diagnosed these lesions should be surgically resected to avoid future possible complications. The Authors present a case of cystic duplication of transverse colon in a young adult male, cause of acute abdominal pain and intestinal obstruction, thus requiring urgent surgery.
Assuntos
Colo Transverso/anormalidades , Cistos/diagnóstico , Obstrução Intestinal/diagnóstico , Dor Abdominal/etiologia , Adulto , Colo Transverso/diagnóstico por imagem , Colo Transverso/cirurgia , Cistos/cirurgia , Diagnóstico Diferencial , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Masculino , Radiografia , Resultado do Tratamento , UltrassonografiaAssuntos
Colo Transverso/anormalidades , Doenças do Colo/complicações , Volvo Intestinal/diagnóstico por imagem , Adulto , Colectomia , Colo Transverso/diagnóstico por imagem , Colo Transverso/cirurgia , Doenças do Colo/diagnóstico por imagem , Doenças do Colo/cirurgia , Colostomia , Diagnóstico Diferencial , Feminino , Humanos , Volvo Intestinal/complicações , Volvo Intestinal/cirurgia , Síndrome , Tomografia Computadorizada por Raios XRESUMO
A case of long diverticular colonic duplication producing acute abdominal pain in a 6-year-old girl is presented. Physical examination showed no signs of acute abdomen at the initial presentation. After a pain-free interval, there was a sudden onset of severe abdominal pain and a large tumor in the lower abdomen was observed. A plain x-ray showed an enormously dilated colonic pouch filled with gas. Excision of the T-shaped duplication and small part of the transverse colon was successful. Because of extensive fibrotic changes in the colon near the opening of duplication, a resection margin of at least 2 cm is recommended.
Assuntos
Abdome Agudo/etiologia , Colo Transverso/anormalidades , Colo Transverso/cirurgia , Divertículo do Colo/cirurgia , Criança , Colo Transverso/patologia , Divertículo do Colo/etiologia , Feminino , Fibrose , HumanosAssuntos
Masculino , Humanos , Criança , Colo/anormalidades , Colo , Diafragma , Fígado , Colo Transverso/anormalidades , SíndromeRESUMO
Colonic duplication is a rare congenital anomaly of the alimentary tract. In most cases, symptomatic duplications of the colon are recognized and treated by childhood. It is uncommon for these lesions to be detected in the adulthood since they present with vague symptoms if at all. We experienced a case of asymptomatic tubular duplication of the transverse colon in a 40-year-old female. Barium enema revealed a tubular duplication of the transverse colon. The duplicated segment arose from the mid ascending colon and incorporated just proximal to the splenic flexure, running parallel to the transverse colon and communicating with it at both ends. Colonoscopy demonstrated a normal colonic mucosa in the duplicated segment. The diameter of its lumen gradually narrowed proximally and the colonoscope could not be passed through the proximal opening of the segment. The patient did not need any treatment. Duplications of the alimentary tract can be found at any age. The possibility of congenital lesions in the adult population should not be overlooked.
Assuntos
Colo Transverso/anormalidades , Adulto , Colo Transverso/diagnóstico por imagem , Colonoscopia , Feminino , Humanos , Mucosa Intestinal/citologia , RadiografiaRESUMO
We describe here a rare case of association of imperforate anus with transverse colon atresia in a male neonate. Preoperative X-ray studies demonstrated: a) a distended loop in the epigastrium with fluid levels on plain A/P upright radiography, b) absence of pelvic intestinal gas on the invertogram 16 hours later. A three-stage operative approach was undertaken comprising resection of the atretic loop and colostomy, posterior sagittal anorectoplasty a few months later, and finally closure of the colostomy. The postoperative outcome was good. The association of these anomalies should be kept in mind in neonates with anal atresia and abdominal distention.