A 34-year-old male presented with spontaneous rectal pain. He was diagnosed with a posterior rectal wall abscess 7 cm proximal to the anal verge that was confirmed on an MRI (magnetic resonance imaging) pelvis. This abscess was drained through a transrectal route. Rectal wall abscess is an exceedingly rare pathology compared to perianal abscess; therefore, this case highlights the key aspects of its management.
A woman and man in their 20s presented to the accident and emergency (A&E) department with abdominal pain, vomiting, and absolute constipation. They both presented as atypical candidates for faecal impaction with few medical and lifestyle risk factors. On CT imaging, a faecolith was visualised in the sigmoid colon as a cause of the large bowel obstruction (LBO) in both patients. A faecolith obstruction can be a life-threatening sequela of faecal impaction. The first line of treatment for LBO is conservative management with oral laxatives and enemas. If this is unsuccessful, interventions such as flexible sigmoidoscopy with the placement of enemas above the blockage can be used. In the event of a compromise to bowel vascularity or if previous interventions prove unsuccessful, there is also scope for surgery. After the resolution of the blockage, follow-up investigations should be performed to elicit an underlying cause in the hope of preventing a recurrence.
Spontaneous regression of cancer is rare, and rarer still in colorectal cancer. We present a report of two cases of spontaneous regression of histologically proven proximal colonic cancers described in detail, alongside endoscopic, histological, and radiological images. We discussed the potential mechanisms by reviewing previous literature.
The falciform ligament is a remnant of the embryonic ventral mesentery containing the obliterated umbilical vein and round ligament. It extends from the umbilicus to the superior aspect of the diaphragm. We report about a 53-year-old fit and well patient who presented with acute upper abdominal pain with tenderness to palpation. Ultrasound scan was unremarkable, but blood tests revealed raised inflammatory markers. Thus, computed tomography was performed. This demonstrated acute torsion and fat necrosis of the falciform ligament, which was the aetiology of the upper abdominal pain. Such pathology is rare with 23 previously reported cases. Conservative management is usually proposed, but on occasion, surgical intervention may be warranted in cases that do not respond to initial supportive measures. We describe this case to demonstrate a rare cause of a common presentation to the surgical service.
Gastrointestinal (GI) metastasis from a primary breast carcinoma is uncommon, with the rectum being one of the least reported sites in the literature. We report a case of a 79-year-old woman who underwent treatment for an infiltrative lobular carcinoma of the right breast with nodal involvement, and 10 years later developed recurrence in the form of rectal metastasis. Spread to the GI tract is most commonly seen with lobular breast carcinomas. Any patient with a history of breast cancer presenting typically or atypically with abdominal symptoms or altered bowel habit should raise a high index of suspicion for recurrent or metastatic disease.
Breast Neoplasms/pathology , Carcinoma, Lobular/secondary , Rectal Neoplasms/secondary , Aged , Female , Humans , Rectum/pathology
BACKGROUND: Pseudomyxoma peritonei is a rare condition consisting of mucinous ascites, most commonly arising from mucinous tumors of the appendix and occasionally from the ovary. Very rarely mucinous implants arise in the retroperitoneum without any intra-peritoneal involvement. This has been termed as pseudomyxoma extraperitonei. CASE PRESENTATION: We report a case of a 57 year old man who developed pseudomyxoma extraperitonei, 35 years after undergoing an appendicectomy for a perforated appendix. CONCLUSIONS: Pseudomyxoma extraperitonei has been previously reported, however we report the longest incubation period of 35 years for this condition.
