RESUMEN
Background: Idiopathic megabowel is a rare condition. Its physiopathology is still unclear. We report a case of a patient presenting with acute bowel obstruction due to idiopathic megacolon and megarectum that was successfully treated with proctocolectomy. Case presentation: A 65-year-old man, with a history of chronic constipation, presented to the emergency with acute bowel obstruction symptoms.His CT scan on admission showed a very dilated rectum and sigmoid colon filled with faeces. The patient was managed conservatively.Due to the deterioration of his condition. We opted for an emergency laparotomy and it revealed the important dilation of the descending colon, the sigmoid colon, and the rectum leading to a Hartmann procedure.degenerative lesions of the smooth muscle layers were seen on the histopthological report and the diagnosis of rectosigmoid idiopathic megacolon was made.Postoperatively, we performed a rectoscopy that showed a distended rectum full of faeces.We performed a proctectomy with colo-anal anastomosis. He had an uneventful recovery. Conclusion: Idiopathic megacolon is a rare condition. The pathogenesis is still unclear. Surgical treatment is the best option to prevent complications and to improve the quality of life of the patient.
RESUMEN
Background: Omental artery aneurysms are extremely rare. Their rupture is related to high mortality and often treated by open surgery. We describe a case of a spontaneous rupture of a left omental artery aneurysm (OAA) that was successfully treated by transcatheter arterial embolization (TAE). Case presentation: A 68-year-old man presented with acute abdominal pain. On examination, he was hypotensive and tachycardic with a blood pressure of 90/50 mm Hg. He had diffuse abdominal distension and tenderness.An abdominal enhanced computed tomography scan (CT) showed a rupture of the left OAA responsible for moderate hemoperitoneum. We performed a successful TAE. Conclusion: Ruptured OAA causes high mortality. OAA represents the rarest form of splanchnic artery aneurysms. Interventional radiology permits to avoid unnecessary surgery.TAE is a safe procedure to control ruptured OAA. We highlight the importance of a rapid embolization if the patient is hemodynamically stable.