Prevascular Richter's hernia a rare and challenging presentation of a potentially life-threatening condition: A rare case report.

INTRODUCTION: Richter's hernia is a relatively uncommon type of hernia that can lead to severe clinical consequences if left unaddressed. The definitive treatment involves the reduction and repair of the hernia defect, with various surgical approaches available, including open transabdominal, inguinal, obturator, and laparoscopic techniques, depending on the size of the defect and the viability of the involved bowel. CASE PRESENTATION: A 29-year-old female patient presented with Richter's hernia, a rare type of hernia, and underwent surgical intervention to release the incarcerated bowel loop and resect the necrotic segment. The case emphasizes the need to consider Richter's hernia in atypical hernia presentations to prevent severe complications. DISCUSSION: Richter's hernia is a distinct type of hernia characterized by the entrapment of a portion of the intestinal circumference, often leading to rapid onset of gangrene without causing intestinal obstruction. The diverse anatomical locations of Richter's hernias, including the rare prevascular variant, emphasize the importance of maintaining a high index of suspicion for this condition, particularly in the context of laparoscopic interventions and atypical hernia presentations. CONCLUSION: Early recognition and prompt referral for appropriate imaging investigations are essential to prevent the significant morbidity and mortality associated with this notoriously challenging-to-diagnose condition, and a heightened awareness and a comprehensive diagnostic approach are crucial to effectively identify and address this rare but potentially life-threatening surgical emergency.

Hypervascular gastrointestinal stromal tumor: a rare case report.

Introduction and importance: To document a case of an ileal gastrointestinal stromal tumor that caused a massive lower gastrointestinal hemorrhage. Case presentation: A 55-year-old man presented with multiple episodes of melena and decreased hemoglobin levels. Computed tomography angiography (CTA) revealed a hypervascularized ileal mass. Clinical discussion: The mass was surgically excised, and the patient's hemoglobin levels stabilized. Histopathological findings confirmed it to be a low-grade gastrointestinal stromal tumor (G1 GIST). Conclusion: GISTs are infrequent clinical entities that should be kept in mind when managing patients with gastrointestinal hemorrhage of unknown origin. Using proper imaging modalities is essential for the accurate diagnosis of such tumors, with CTA proving to be particularly effective in identifying hypervascularized tumors.

Upper gastrointestinal tract obstruction caused by a gossypiboma: A rare surgical case report.

INTRODUCTION: Gossypiboma is a term used to describe a condition of leaving a surgical sponge or any other foreign object in a body cavity after surgery. Gossypiboma is a rare but serious medical and legal problem, as it may cause no symptoms or severe complications in the digestive system. In some cases, Gossypiboma may migrate through the wall of an organ and cause damage, such as perforation, obstruction, or fistula formation. CASE REPORT: A 46-year-old male presented to the Emergency Department with abdominal pain, diarrhea, vomiting, and weight loss of about 15 kg through 20 days. The condition developed into constipation. DISCUSSION: The prevalence of complications, known as Gossypibomas, is relatively rare but can cause inflammatory reactions, abscesses, and other complications. Diagnosis is challenging and may require thorough evaluation, imaging, and exploratory surgery. Treatment usually involves surgical removal, either through laparoscopy or laparotomy. Prevention methods, such as accurate counting and implementing surgical safety protocols, are crucial to avoid such incidents. CONCLUSION: Performing a thorough count of all surgical sponges and instruments at both the start and conclusion of the procedure is the most effective method to prevent Gossypiboma. Other preventive measures include using radiopaque sponges and making sure that all sponges are accounted for before closing the incision.

Unusual cause of chronic abdominal pain in a 17-year-old female: a case report of an epithelial adrenal cyst.

Adrenal cysts are rare lesions that make up 4% of all adrenal masses. They are often found incidentally during imaging or surgery and can vary in symptoms depending on their size and location; with cysts < 10 cm often being asymptomatic. These cysts are more common in adults in their 30s or 60s and can be divided into four histological subtypes, with epithelial cysts being less common. We present a case of a 17-year-old female who experienced recurrent right flank pain for a year. Ultrasonography revealed a cystic mass on the right kidney, and computerized tomography showed a well-defined suprarenal cyst measuring ~8 cm misdiagnosed as mesenteric cyst. However, during laparoscopy, an adrenal cyst was discovered, which was excised along with the right adrenal gland. Histopathology confirmed the diagnosis of an epithelial adrenal cyst. This case highlights the occurrence of adrenal cysts in younger individuals and the uncertainty of preoperative diagnosis.