Operative management of splenic rupture and hepatic flexure injury during diagnostic colonoscopy in a patient with adenocarcinoma of the cecum.

Diagnostic colonoscopy has evolved to become the gold standard for the screening for carcinoma and other diseases of the colon. Injuries to the colon are rare and may be managed in a variety of ways. This includes observation and bowel rest or operative intervention and repair. Other organs are at risk during colonoscopy. The present report describes a patient who underwent colonoscopy for the work-up of anaemia. Following colonoscopy she developed signs of haemorrhagic shock and was found to have haemoperitoneum. She underwent surgery, and adenocarcinoma of the cecum was identified and managed during exploration. The clinical management is described.

Laparoscopic cholecystectomy for a left-sided gallbladder.

Cholecystectomy is a common procedure. Abnormalities in the anatomy of the biliary system are common but an abnormal location of the gallbladder is much rarer. Despite frequent pre-operative imaging, the aberrant location of the gallbladder is commonly discovered at surgery. This article presents a case of a patient with the gallbladder located to the left of the falciform ligament in the absence of situs inversus totalis that presented with right upper quadrant pain. A laparoscopic cholecystectomy was performed and it was noted that the cystic duct originated from the right side. The presence of a left sided gall bladder is often associated with various biliary, portal venous and other anomalies that might lead to intra-operative injuries. The spectrum of unusual positions and anatomical gallbladder abnormalities is reviewed in order to facilitate elective and emergent cholecystectomy as well as other hepatobiliary procedures. With proper identification of the anatomy, minimally invasive approaches are still considered safe.

Video-assisted thoracoscopic surgery for intralobar pulmonary sequestration.

INTRODUCTION: Intralobar pulmonary sequestration is a rare congenital abnormality of the lower respiratory system, which becomes symptomatic early in life. Standard treatment consists of wedge resection or lobectomy through a thoracotomy. CASE PRESENTATION: We report on an unusual case of a 36-year-old female patient with intralobar pulmonary sequestration on the right lower lobe, which was treated with video-assisted thoracic surgery. The case is presented along with literature review. CONCLUSION: VATS wedge resection is a great alternative to the traditional thoracotomy for the treatment of intralobar pulmonary sequestrations.