Primary angiosarcoma of the breast: Diagnosis with computer-assisted MRI-guided radio-guided occult lesion localization (ROLL) technique.

Primary angiosarcoma of the breast is a rare type of breast cancer that represents approximately 0.04% of all primary breast tumors. We report herein a case of primary breast angiosarcoma that was only visible on magnetic resonance imaging (MRI) examination. The patient presented with a palpable right breast lump that was not visible either on ultrasonography and mammography. MRI showed a lesion of the right breast that presented washout kinetics. MRI-guided biopsy allowed histopathological examination of the tumor that was further confirmed as primary angiosarcoma. Subsequently, MRI guided ROLL (radio-guided occult lesion localization) technique was used for localizing the lesion prior to surgery.

Computed tomography features of small bowel obstruction due to mesodiverticular band.

Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to a Meckel's diverticulum include hemorrhage, intestinal obstruction, and inflammation. Small bowel obstruction due to mesodiverticular band of Meckel's diverticulum is a rare complication. Herein, we report a case of small bowel obstruction occurring due to mesodiverticular band of a Meckel's diverticulum. The important aspect of our case is clear demonstration of the mesodiverticular band adjacent to the Meckel's diverticulum on pre-operative computed tomography (CT).

Omitting of bougie appears to be safe for the performance of the fundal wrap at laparoscopic Nissen fundoplication.

AIM: Some operative techniques in fundoplication seem to increase the incidence of obstructive symptoms. Some authors believe that using intraesophageal bougie and preparing a short and floppy valve in laparoscopic Nissen fundoplication will help to decrease any possible tight crus repair and wrap and so it is effective to decrease the prevalence of postoperative dysphagia. The aim of this study is to show that there is no absolute benefit of routine insertion of a bougie during laparoscopic Nissen fundoplication in relation to post-operative dysphagia. METHODS: All patients who underwent laparoscopic Nissen fundoplication by a single surgeon between January 2001 and August 2011 were reviewed retrospectively. Esophageal bougie intubation was performed in none of the 154 patients. The operation technique, the duration of the operation, hospital stay and the improvement of the symptoms were assessed. The patients who had esophagitis with Barrett's esophagus and who had hiatal hernia that could not get benefit from medical therapy, were selected for the surgery. Laparoscopic Nissen fundoplication with cruroraphy were done in all patients. RESULTS: Ninety-six of the patients were female and 58 were male. The mean symptom duration was 3.6±0.6 years. The only complication was dysphagia. In eighth week, dysphagia resolved in all patients. CONCLUSION: Laparoscopic Nissen fundoplication can be safely performed without the routine use of an esophageal bougie and it does not increase the postoperative dysphagia rate.