scholarly journals 187 A Rare Case of Colovesical Fistula in A Patient with Situs Inversus

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Ben Hmida ◽  
O Sheikh
Keyword(s):  
Situs Inversus ◽  
Rare Case ◽  
Primary Anastomosis ◽  
Anatomical Variation ◽  
Bladder Wall ◽  
Fistula Formation ◽  
Stent Insertion ◽  
Sigmoid Colectomy ◽  
Colovesical Fistula ◽  
Tract Infections

Abstract A 47 year old man with no past medical history presented to the urology clinic with recurrent urinary tract infections caused by E.Coli. He subsequently had a number of investigations including imaging and cystoscopy which showed a high possibility for a colovesical fistula and incidentally demonstrated subdiaphragmatic Situs inversus. The sigmoid colon was inflamed and adherent to the posterior wall of the bladder. Surgical management following a multi-disciplinary decision resulted in an elective Ureteric stent insertion followed by laparotomy with sigmoid colectomy and primary anastomosis. The bladder wall defect caused by fistula formation was repaired. We report an extremely rare case of colovesical fistula in the setting of subdiaphragmatic situs inversus in a relatively young patient. This would likely be seen in older patients with more severe diverticulitis and usually in an acute setting. Anatomical variation resulted in more severe diverticular disease and predisposed to fistula formation.

scholarly journals A Rare Case of Adult Aortopulmonary Window Combined with Anomalous Origin of the Right Pulmonary Artery from the Aorta Leading to Eisenmenger Syndrome

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098465
Author(s):  
Mingyue Cui ◽  
Binfeng Xia ◽  
Heru Wang ◽  
Haihui Liu ◽  
Xia Yin
Keyword(s):  
Pulmonary Artery ◽  
Rare Case ◽  
Congenital Heart ◽  
Respiratory Tract Infections ◽  
Anomalous Origin ◽  
Aortopulmonary Window ◽  
Eisenmenger Syndrome ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Tract Infections

Aortopulmonary window is a rare congenital heart disease that can increase pulmonary vascular resistance, exacerbate left-to-right shunt and lead to heart failure and respiratory tract infections. Most patients die during childhood. We report a 53-year-old male patient with a large aortopulmonary window combined with anomalous origin of the right pulmonary artery from the aorta, with Eisenmenger syndrome and without surgery.

scholarly journals A rare case of goldenhar syndrome with situs inversus

2021 ◽  
Vol 59 (1) ◽  
pp. 107
Author(s):  
DSakthi Priya ◽  
SharmilaDevi Vadivelu ◽  
GThiruvengada Senthil Kumar ◽  
B Meenakshi ◽  
Nivetha Gandhi
Keyword(s):  
Situs Inversus ◽  
Rare Case ◽  
Goldenhar Syndrome

scholarly journals Double Rarity: Malignant Masquerade Biliary Stricture in a Situs Inversus Totalis Patient. A Case Report

2020 ◽  
Author(s):  
Katalin Eitler ◽  
Zoltan Mathe ◽  
Veronika Papp ◽  
Attila Zalatnai ◽  
Andras Bibok ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Situs Inversus ◽  
Anatomical Variation ◽  
Significant Risk ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Situs Inversus Totalis ◽  
Recent Onset ◽  
Benign Biliary Strictures ◽  
Duct Stricture

Abstract Background. Situs inversus totalis is a rare anatomical variation of both the thoracic and the abdominal organs. Common bile duct strictures can be caused by malignant and benign diseases as well. 7-18% of the latter ones are 'malignant masquerade’ cases, as pre-operative differentiation is difficult. Case presentation. We present the case of a 68y male patient with known situs inversus totalis and a recent onset of obstructive jaundice caused by a malignant behaving common bile duct stricture. Technically difficult endoscopic retrograde cholangiopancreatography, brush cytology, magnetic resonance cholangiopancreatography, endoscopic ultrasound, and percutaneous transhepatic drainage with stent implantation were performed for proper diagnosis. Cholecystectomy, common bile duct resection with hilar lymphadenectomy and a hepatico-jejunostomy has been performed following multidisciplinary consultation. The final histology report did not confirm any clear malignancy, the patient is doing well.Conclusion. In situs inversus patients, both diagnostic and therapeutic procedures can lead to various difficulties. Benign biliary strictures are frequently misdiagnosed preoperatively as cholangiocellular carcinoma. The surgery is usually unavoidable, involving a significant risk of complications.The co-existence of these two difficult diagnostic and therapeutic features made our case challenging.

scholarly journals Bacterial Pericarditis Caused by Penetration of a Migrated Biliary Stent from the Lateral Segment of the Liver: A Case Report

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 132
Author(s):  
Hsiao-Yun Chao ◽  
Chih-Huang Li ◽  
Shou-Yen Chen
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Early Detection ◽  
Adverse Events ◽  
Patient Outcomes ◽  
Rare Case ◽  
Biliary Stent ◽  
Stent Insertion ◽  
Distal Migration ◽  
Bacterial Pericarditis

Endoscopic biliary stent insertion is a well-established procedure that is indispensable in the management of various benign and malignant biliary disorders, and one that helps prevent mortality related to invasive surgical procedures. We report a rare case of the distal migration of a biliary stent outside the abdomen to the pericardium, inducing constrictive pericarditis and septic shock. This case alerts clinicians to be aware of potential adverse events that can lead to unfavorable patient outcomes. Such adverse events can be effectively avoided through early detection and intervention.

scholarly journals A Rare Case of Situs Inversus with Mesocardia

2014 ◽  
pp. 1-3
Author(s):  
Sajith JS ◽  
◽  
Gobbur RH ◽  
Koti P ◽  
Patil SV
Keyword(s):  
Situs Inversus ◽  
Rare Case

Hemihyperplasia with Multiple intestinal Lipomatosis presenting with intestinal obstruction due to intussusception, challenges in treatment- A Rare case

2021 ◽  
Vol 12 (4) ◽  
pp. 149-152
Author(s):  
Pushpendra Malik ◽  
Mahinder K Garg
Keyword(s):  
Intestinal Obstruction ◽  
Large Bowel ◽  
Rare Case ◽  
Primary Anastomosis ◽  
Right Hemicolectomy ◽  
Operative Intervention ◽  
Genetic Syndrome

Hemihyperplasia is a syndrome with overgrowth of limbs and associated with various genomic syndromes. Rarely patient presents with intestinal obstruction when it is associated with sub mucosal lipomas. Submucosal lipomas are common in colon. But whole of small and large bowel studded with them is very rare as in our case. It presents dilemma not only in diagnosis but in treatment also. Here we present a case of forty two years females with hemihyperplasia syndrome came to causality with recurrent intestinal obstruction. On CECT Abdomen diagnosis of intestinal obstruction due to intussusception was made. Whole of bowel is studded with submucosal lipomas. Patient was tried to manage conservatively but patient does not respond and Right Hemicolectomy was done of intussusception segment. Anastomosis leaked and on re-exploration end ileostomy was done. Obstruction due to Multiple Intestinal Lipomatosis (as a part of Genetic Syndrome) should be managed conservatively and if operative intervention is required avoid primary anastomosis.

scholarly journals A rare case of a closed loop obstruction due to epiploic appendage of the sigmoid colon

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Rathin Gosavi ◽  
Ee Ban
Keyword(s):  
Small Bowel ◽  
Sigmoid Colon ◽  
Rare Case ◽  
Closed Loop ◽  
Primary Anastomosis ◽  
Uterine Cancer ◽  
Small Bowel Resection ◽  
Uneventful Recovery ◽  
Ischemic Bowel ◽  
The Right

Abstract An internal hernia is a protrusion of viscera through a congenital or acquired defect in the mesentery of peritoneum. They account for <0.9% of all small bowel obstructions [1] and ~4% of obstructions due to hernias [2]. We present a rare case of closed loop obstruction secondary to a band adhesion traversing the lower abdomen from a sigmoid colon appendage epiploicae to the right pelvic wall. A 82-year-old woman presented to the emergency department with nausea, vomiting and worsening right sided abdominal pain for 24 h, on the background of previous pelvic radiation and hysterectomy for uterine cancer. She was subsequently found to have a closed loop obstruction with 30 cm of ischemic bowel strangulated by a band adhesion from a sigmoid colon appendage epiploicae to the right abdominal wall. The patient underwent a successful small bowel resection with primary anastomosis and made an uneventful recovery.

scholarly journals Incidence of bacterial colonisation after indwelling of double-J ureteral stent

2016 ◽  
Vol 87 (4) ◽  
pp. 291 ◽  
Author(s):  
Hasan Riza Aydin ◽  
Lokman Irkilata ◽  
Mustafa Aydin ◽  
Selim Gorgun ◽  
Hüseyin Cihan Demirel ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Early Period ◽  
Stent Insertion ◽  
Bacterial Colonisation ◽  
E Coli ◽  
Double J Stent ◽  
Aseptic Conditions ◽  
Tract Infections

Objective: To determine the bacterial colonisation after double-J stent use and the risk factors for bacteriuria linked to the stent. Materials and Methods: A total of 102 patients (61 men and 41 women, mean age 47.5 ± 14.16) were examined. The stents were removed under aseptic conditions, and a urine culture was obtained before the removal of the stents. After the stents were removed, the upper, central and lower sections were separated, and washing water was sent through the stent. Results: Bacterial colonisation was found in 29.4% (30 of 102) of the stents. The most frequently observed microorganisms were determined as staphylococcus, coagulase negative (8 of 30) and E. coli (5 of 30). The washing fluid used to clean the interior of the catheter produced pathogens in 8 patients (7.8%), and these pathogens were observed to be the same microorganisms that colonised the outside of the stent. There was no statistical difference between the patients with colonisation and those without in terms of age, gender, duration of stenting and reason for stent insertion. Conclusions: Though stent colonisation does not always entail symptomatic urinary tract infections, as shown in our study, the pathogens in the urine culture are the same as those colonising the stent, confirming the reality that colonisation is the main factor in these events. Additionally, according to our study, significant colonisation may be found in the first 3 weeks, contrary to the literature, causing us to consider that urinary tract infections may develop even in the early period.

What Is the Relationship between Operative Time and Adverse Events after Colon and Rectal Surgery?

2018 ◽  
Vol 84 (5) ◽  
pp. 712-716 ◽  
Author(s):  
Gabriela Poles ◽  
Caitlin Stafford ◽  
Todd Francone ◽  
Patricia L. Roberts ◽  
Rocco Ricciardi
Keyword(s):  
Colorectal Surgery ◽  
Adverse Events ◽  
Operative Time ◽  
Primary Anastomosis ◽  
Multivariable Analysis ◽  
Rectal Surgery ◽  
Surgical Site Infections ◽  
Colon And Rectal Surgery ◽  
Improvement Program ◽  
Tract Infections

We propose that prolonged colorectal surgery operative times are associated with increased 30-day adverse events. We identified a cohort from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) from January 2005 through December 2012. Patients who underwent colectomy with primary anastomosis were selected using CPT codes. Operative time was categorized into short, average, and long based on mean operative times 61 SD. NSQIP-approved multivariate models were used to identify associations between operative time and 30-day adverse events. A total of 113,615 patients underwent colorectal resection of which 46 per cent were laparoscopic and 12 per cent were identified as long operative times. Patients with long operative procedures had 34 per cent more superficial surgical site infections, 65 per cent more organ space infections, 69 per cent more abdominal dehiscences, 44 per cent more thrombotic complications, 45 per cent more urinary tract infections, 40 per cent more returns to the operating room, and 36 per cent more prolonged lengths of stay ( P < 0.05 for all analyses). The multivariable analysis revealed an association between long operative times and increased adverse events despite adjustment for all NSQIP recommended covariates. Our results reveal increased 30-day adverse events with increased operative time. We propose that operative time may serve as a proxy for surgical complexity in colorectal surgery.

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