Meckel's diverticulum: A rare cause of acute intestinal occlusion.

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract (Lequet et al., 2017). It results from incomplete obliteration of the vitelline (omphaloenteric) duct. Observed diverticulum complications include inflammation and perforation, hemorrhage and obstruction (Kawamoto et al., 2015). We are reporting on a case of Meckel's diverticulum revealed by acute intestinal obstruction.

An epigastric mass? And what if it was an intra-abdominal esophageal duplication cyst: Case report.

INTRODUCTION AND IMPORTANCE: Duplication of the alimentary tract are uncommon congenital malformations that may be found anywhere from mouth to anus. Esophageal cystic duplication is a congenital cystic malformation of the alimentary tract consisting of a duplication of the segment of the esophagus to which it is adjacent. CASE PRESENTATION: We report the case of a 29-year-old female who had complained of intermittent epigastric pain and post prandial nausea for several weeks. Physical examination was without particularity except for the presence of abdominal epigastric mass. Transabdominal sonography combined with CT scan showed an epigastric cyst with no topographic relation to the pancreas measuring about 80 mm in diameter. Because of persistence of the epigastric pain and the nausea we decided to operate the patient. Histological exam than showed that the cystic mass was in fact an esophageal cystic duplication with no histological signs of malignancy. CLINICAL DISCUSSION: Here we describe a case of intra-abdominal esophageal duplication cyst in adult patient. Most of duplications cause symptoms in infancy or early childhood. Digestive duplication revealed at adulthood is a condition considered rare. CONCLUSION: Esophageal duplication cysts are uncommon developmental lesions arising from the primitive foregut, when diagnosed or encountered incidentally. The diagnosis of this anomaly in adulthood is exceptional and requires surgery.

Surgical management of benign noninfected urachal cysts in adult patients: two case reports.

BACKGROUND: Abnormalities of the urachus include the patent urachus, cysts, sinus, and fistula. Each of these entities represents a failure of complete obliteration of the urachus. Contrary to other urachus anomalies, urachal cysts are usually small and silent unless they are infected. The diagnosis is often made during childhood. A benign noninfected urachal cyst discovered in adulthood is a rare condition. CASE PRESENTATION: Herein we report two cases of benign noninfected urachal cysts in adults. The first case is a 26-year-old Tunisian white man who presented with complaints of clear fluid draining from the base of the umbilicus evolving for a week, with no other associated symptoms. The other case was 27-year-old Tunisian white woman who was referred to the surgery department with a history of intermittent draining of clear fluid from the umbilicus. The two cases had laparoscopic resection of urachus cysts. DISCUSSION: Laparoscopy represents a good alternative for the management of persistent or infected urachus, especially when this is suspected, despite a lack of radiological evidence. Laparoscopy in the management of urachal cysts is safe, effective, and offers good cosmesis, with all the advantages of a minimally invasive approach. CONCLUSION: Managing persistent and symptomatic urachal anomalies requires a wide surgical excision. Such intervention is recommended to prevent symptom recurrence and complications, most notably malignant degeneration. A laparoscopic approach offers excellent outcomes, and is recommended to treat these abnormalities.

Closed loop small bowel obstruction due to small intestine volvulus associated with early adhesion after laparoscopic appendectomy: Case report and review of the literature.

INTRODUCTION AND IMPORTANCE: Nowadays the majority of appendectomies are undertaken laparoscopically. The associated per and postoperative complications are well established and known. However, some rare postoperative complications continue to be reported such as small bowel volvulus. CASE PRESENTATION: We report the case of 44-year-old women who developed a small bowel obstruction from acute small bowel volvulus due to early postoperative flanges five days after a laparoscopic appendectomy. CLINICAL DISCUSSION: Laparoscopy is associated with less adherences and morbidity however we must be careful in post operative course. Mechanical obstruction can happen even with laparoscopy procedure. CONCLUSION: Occlusion earlier after surgery even with laparoscopy procedure must be explored. Volvulus can be incriminated.

Septate gallbladder: A rare congenital anomaly.

The septate gallbladder is a rare congenital malformation. It is considered a risk factor of complications after laparoscopic cholecystectomy. We are reporting an image in surgery of a septate gallbladder. It was discovered at an adult age. We are showing the difficulty of the diagnosis preoperatively on the radiological find.

Idiopathic sclerosing encapsulating peritonitis: An uncommon cause of intestinal obstruction in a virgin abdomen.

Idiopathic sclerosing encapsulating peritonitis is a clinical entity characterized by partial or complete encasement of the digestive tract by a fibrous membrane. The preoperative diagnosis is difficult to establish. The diagnosis of sclerosing encapsulating peritonitis should be considered for patients without any surgical history and admitted for intestinal obstruction, especially for patients having peritoneal dialysis. We herein report the case of a 50-year-old man with idiopathic encapsulating peritonitis complicated by intestinal obstruction and ischemia. Idiopathic sclerosing encapsulating peritonitis is a rare disease. The diagnosis is made generally during a surgical procedure. Surgery seems to be the best management option for patients with severe signs of intestinal obstruction. Total resection of membrane avoids recurrences but it is associated with higher morbidity and mortality.

A 34-year-old asymptomatic gossypiboma: A fortuitous diagnosis revealed by appendicular peritonitis: A case report.

Gossypiboma is a retained surgical sponge. Patients are usually symptomatic leading to early removal of this entity. We are reporting a 33-year-old asymptomatic gossypiboma discovered by appendicular peritonitis on the radiological images. The 64-year-old patient underwent a laparotomy with excision of the gossypiboma. The postoperative period was uneventful.