RESUMO
A 40-year-old man presented with acute abdominal pain and falling haemoglobin after a history of minor abdominal trauma. Radiological imaging showed a large soft tissue mass situated between the anterior stomach wall and peritoneum. At diagnostic laparoscopy, intra-abdominal blood and an encapsulated haematoma were found. The procedure was converted to midline laparotomy and the mass was excised, including a stalk of tissue that connected the mass to the anterior prepyloric stomach wall. The patient recovered well and was discharged after 9 days. Histology confirmed a gastrointestinal stromal tumour surrounded by haematoma formation.
Assuntos
Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Neoplasias Gastrointestinais/diagnóstico , Tumores do Estroma Gastrointestinal/diagnóstico , Hematoma/etiologia , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adulto , Biópsia por Agulha , Serviço Hospitalar de Emergência , Seguimentos , Hemorragia Gastrointestinal/diagnóstico por imagem , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/cirurgia , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/cirurgia , Hematoma/diagnóstico por imagem , Hematoma/cirurgia , Humanos , Imuno-Histoquímica , Escala de Gravidade do Ferimento , Laparoscopia/métodos , Laparotomia/métodos , Masculino , Radiografia , Medição de Risco , Ruptura/cirurgia , Resultado do TratamentoRESUMO
The authors report a patient who suffered a penetrating knife injury to the right thoracoabdominal region which penetrated through the liver and both sides of the gallbladder. This injury was treated successfully by laparotomy and cholecystectomy.
Assuntos
Traumatismos Abdominais/cirurgia , Vesícula Biliar/lesões , Fígado/lesões , Traumatismos Torácicos/cirurgia , Ferimentos Perfurantes/cirurgia , Traumatismos Abdominais/diagnóstico , Adulto , Colecistectomia/métodos , Seguimentos , Vesícula Biliar/cirurgia , Humanos , Escala de Gravidade do Ferimento , Laparotomia/métodos , Fígado/cirurgia , Masculino , Traumatismo Múltiplo/diagnóstico , Traumatismo Múltiplo/cirurgia , Medição de Risco , Traumatismos Torácicos/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ferimentos Perfurantes/diagnósticoRESUMO
A Morgagni hernia is a rare diaphragmatic hernia which develops through a congenital defect in the retrosternal area, usually on the right hand side. Because of its congenital aetiology, Morgagni hernias are rarely considered in the differential diagnosis of gastric outlet obstruction symptoms in adults. We present a patient with an incarcerated Morgagni hernia who presented with gastric outlet obstruction. A 77-year-old woman presented with symptoms and signs of gastric outlet obstruction, dehydration and acute renal impairment. She was treated by fluid resuscitation and nasogastric tube insertion. Radiological imaging showed a Morgagni hernia containing stomach, omentum and colon. This was treated surgically via an abdominal approach and the defect was closed with mesh. The patient recovered well from this procedure and was discharged. We discuss the anatomy, clinical presentation and surgical treatment of this rare diaphragmatic hernia to raise awareness among surgeons and surgical trainees.
