ABSTRACT
Early gastric and oesophageal perforations are rare following laparoscopic fundoplications, with an incidence of 0.9%. If managed operatively, omentopexy or redo-fundoplication may be employed. Here, we present the case of a septic 21 year old patient who presented with an early gastro-oesophageal perforation 7 days following laparoscopic Nissen fundoplication, which was successfully repaired endoscopically using haemostatic clips. To date, this technique of perforation repair in the setting of fundoplication has yet to be reported.
ABSTRACT
Colo-uterine fistulas are rarely reported in the literature, and its presentation in the presence of a tubo-ovarian abscess secondary to chronic sigmoid diverticulitis is currently not reported. As such, its presentation may pose a diagnostic dilemma. Here, we present a 68-year-old woman who was admitted under the colorectal service with a 1 month history of mild left iliac fossa pain, with computed tomography (CT) demonstrating complicated sigmoid diverticulitis. Progress CTs, however, demonstrated a progressively enlarging left iliac fossa mass, with air fluid levels, densely adherent to the sigmoid colon. The decision was eventually made to perform a laparoscopy, which demonstrated a left tubo-ovarian abscess communicating with the uterus and sigmoid colon, illustrating a colo-uterine fistula. Open resection of the sigmoid colon and uterus was performed and the patient recovered uneventfully. This case describes an uncommon complication of chronic sigmoid diverticulitis and the importance of its judicious surgical management.
Subject(s)
Crohn Disease , Ileal Neoplasms , Intestinal Obstruction , Constriction, Pathologic/diagnostic imaging , Constriction, Pathologic/etiology , Constriction, Pathologic/surgery , Crohn Disease/complications , Humans , Ileal Neoplasms/complications , Ileal Neoplasms/diagnostic imaging , Ileal Neoplasms/surgery , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestine, Small/diagnostic imagingABSTRACT
Ileal conduit volvulus is a rare complication of urinary diversion. It has been suggested that various factors including prolonged length of the ileal segment, lack of fixation of the conduit to the peritoneum and failure to close the incised mesentery predispose patients to this complication. We present the case of a 76-year-old man who presented to hospital with severe abdominal pain and oliguria secondary to a volvulus of his ileal conduit. Investigations revealed early acute kidney injury as a result of urinary obstruction which was evident on abdominal CT. The patient subsequently underwent operative repair of the volvulus. Symptoms resolved following the procedure, kidney function improved and the patient was discharged without complication.
