Abdominal textiloma mimicking as gastrointestinal stromal tumor: A case report.

INTRODUCTION AND IMPORTANCE: Gossypiboma or textiloma is a mass comprising of cotton matrix within the body left accidentally during a surgical procedure. The body may react to this foreign body through an exudative inflammatory reaction or an aseptic fibrotic reaction in order to encapsulate the cotton material and result into a mass. CASE PRESENTATION: We report a case of 65-year-old female. She was referred to our department due to 2 episodes of nausea and vomiting. She had history of open cholecystetomy 29 years ago, then cure for eventration one year after. On exploratory laparotomy there was a mass measuring 6 cm axis at the expense of segment 3 of the liver coming into intimate contact with the duodenum. Atypical segmental hepatectomy of segment 3 of liver was performed, and the histological report confirmed necrotic textiloma. CLINICAL DISCUSSION: Textiloma represents a complication of all forms of surgery. It is a real, serious but preventable surgical complication, and could present with various complaints. Prevention of this condition can be achieved by meticulous count of surgical materials. CONCLUSION: The embarrassment faced by the surgeon and the medico legal implications of this iatrogenic complication are tremendous and all preventive measures should be taken to avoid this as no excuse is justifiable.

A late post-traumatic diaphragmatic hernia revealed during pregnancy by post-partum respiratory distress.

INTRODUCTION: Diaphragmatic hernia during pregnancy is uncommon and is usually traumatic in origin, epigastric pain, and vomiting could be the initial symptoms of herniation of gastrointestinal contents, with a risk of strangulation and ischaemia, leading to respiratory distress due to collapse of the lung. METHODS: Case report. RESULTS: A 27-year-old woman, with undiagnosed traumatic diaphragmatic hernia who presented, at 32 weeks' gestation, epigastric pain, vomiting and tachycardia, immediate post-partum course was complicated by respiratory failure. A chest X-ray showed an air fluid level in the left lung which was wrongly diagnosed as an hydropneumothorax, in front of respiratory symptoms exacerbation, an inappropriate thoracic drainage tube was accidentally placed into the herniated stomach leading to perforation of this last. An emergency laparotomy discovered a 2/3 of the stomach, transverse colon and greater omentum herniated in the left hemithorax through a defect of the left hemidiaphragm. CONCLUSION: The diagnosis should then be considered early, and chest radiography with a nasogastric tube is the first technique to prefer and may be helpful to confirm the diagnosis.

[Situations of conversion during laparoscopic cholecystectomy: series of 300 cholecystectomies]. / Les situations de conversions lors de la cholecystectomie laparoscopique. A propos d'une serie de 300 cholecystectomies.

Laparoscopy is the "gold standard" for cholecystectomy, wherever it can happen that the surgeon must converse to laparotomy. The authors report 300 cases of laparoscopic cholecystectomy; the conversion rate was 9%; for cholecystitis (19%), cystic hemorrhage (3.7%) common bile duct (7.4%) and failure of material (11%). It resort from that study that laparoscopic cholecystectomy is safe, wherever it keeps some limits and conversion still remains a security and don't be assimilated to a failure.

[Pancreaticogastric anastomosis after pancreatic resection. About 40 cases]. / Anastomose pancreatico gastrique apres resection pancreatique. A propos de 40 cas.

The risk of pancreaticojejunal anastomosis fistulization represents the main factor of mortality and morbidity after pancreatic resection. The pancreatogastrostomy represents a technical alternative that can be achieved easily. The purpose of our study is to report our experience of this technique and to analyse respectively 40 pancreactogastric anastomosis after 29 cephalic duodenopancreatectomies and 11 corporeocaudal pancreatectomies. The operative sequelae have been characterized by 5 cases (12.5%) of digestive hemorrhages, 3 cases (7.5%) of pancreatic fistula, 3 cases (7.5%) of intra-abdominal bleeding and a lymphorrhagia (2.5%). The operative mortality rate was about 5% (2 cases). These results are similar to the results reported in the literature by the users of this technique.

[Retroperitoneal cystic lymphangioma]. / Le lymphangiome kystique rétropéritonéal.

Cystic lymphangioma (CL) is a rare benign tumour that may arise in various sites. The retroperitoneal site of CL is less frequent than the mesenteric site. It has a polymorphic clinical presentation. The authors report the case of a 60-year-old woman presenting with a mass and pain in the right iliac fossa and right flank. Clinical examination revealed a cystic mass occupying the right flank and right iliac fossa extending as far as the hypogastrium. Medical imaging was in favour of a retroperitoneal cystic mass. Surgical exploration revealed a retroperitoneal cystic mass. Histological examination concluded on retroperitoneal cystic lymphangioma. The diagnosis of CL can be suggested by imaging, either during the antenatal period or in adults, but must be confirmed by histology. The treatment of choice is surgical.