Preferential Mobilization of Colonic Hepatic Flexure Facilitates Pancreaticoduodenectomy Procedures

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hongyin Liang ◽  
Long Cheng ◽  
Hongtao Yan ◽  
Jianfeng Cui
Keyword(s):  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Akihiro Yoshida ◽  
Yasutake Uchima ◽  
Naoki Hosaka ◽  
Kosuke Minaga ◽  
Masatoshi Kudo

Abstract Background Colonic volvulus, a condition in which a colonic segment partially twists around its base, is the third leading cause of large bowel obstruction after colonic neoplasms and diverticular disease. However, volvulus of the transverse colon is the rarest type of large intestinal volvulus. Moreover, the occurrence of transverse colonic volvulus secondary to a benign tumor originating from outside the intestine has never been reported. We hereby report a case of transverse colonic volvulus caused by mesenteric fibromatosis. Case presentation A 53-year-old female with a history of rheumatoid arthritis and thyroid tumor presented with abdominal pain for 1 day. Abdominal computed tomography revealed intestinal torsion at the hepatic flexure. Twisted and obstructed mucosa of the transverse colon was observed during colonoscopy, but no tumor invasion of the mucosal surface was detected. A solid mass of a mesenteric origin with involvement of the transverse colon was observed during surgery. The mass was diagnosed surgically as transverse colonic volvulus induced by a mesenteric tumor. Hence, the patient underwent a right hemicolectomy. Histopathological results indicated mesenteric desmoid-type fibromatosis. The postoperative recovery was uneventful, and the patient was discharged 8 days after surgery. Conclusions Although mesenteric fibromatosis is rare, this disease should be considered when managing transverse colonic volvulus resulting from nonmucosal tumors.


1996 ◽  
Vol 37 (1P1) ◽  
pp. 255-258 ◽  
Author(s):  
D. Makanjuola ◽  
S. Al-Smayer ◽  
I. Al-Orainy ◽  
M. Al-Saleh

Purpose: Our aim was to describe the radiographic features of lobar agenesis of the liver. Material and Methods: Six patients with lobar agenesis of the liver, 5 right- and one left-sided, are presented. CT was used to confirm diagnosis. Chest radiography, barium meals, and urograms were also analyzed. Results: In right-sided agenesis, the following were observed: a) hammock or U-shaped deformity of the stomach; b) colonic interposition of the diaphragm (Chilaiditi's syndrome); and c) reversal of the cranial orientation of the colonic hepatic flexure compared to the splenic flexure. The right kidney was higher in position than the left in both right- and left-sided lobar agenesis. Conclusion: Our radiographic findings can provide a multidisciplinary approach in the identification of this anatomic anomaly.


BMJ ◽  
1947 ◽  
Vol 2 (4519) ◽  
pp. 249-250 ◽  
Author(s):  
R. W. Raven
Keyword(s):  

2005 ◽  
Vol 33 (3) ◽  
pp. 360-363 ◽  
Author(s):  
A Polychronidis ◽  
AK Tsaroucha ◽  
AJ Karayiannakis ◽  
S Perente ◽  
E Efstathiou ◽  
...  

We report a case of delayed perforation of the large bowel because of thermal injury during a laparoscopic cholecystectomy. A 78-year-old male with symptomatic cholelithiasis underwent a difficult laparoscopic cholecystectomy because of multiple adhesions resulting from two previous cholecystitis episodes. The patient recovered well after surgery and was discharged on post-operative day 2. On postoperative day 10, the patient returned to the hospital with peritonitis. An exploratory laparotomy revealed perforation of the wall of the hepatic flexure of the large bowel, which was centred in a necrotic area 1 cm in diameter. The perforation was sutured and a temporary ileostomy performed, which was closed at a later date. The patient was doing well at a 10-month follow-up review. A delayed rupture of any part of the bowel after laparoscopic surgery can be potentially fatal if not treated during an emergency exploratory laparotomy, even if the clinical signs are not severe.


2021 ◽  

We presented a 60-year-old man who underwent a colonoscopy examination of a polypoid mass with a wound surface of 1.1 cm in hepatic flexure. An adenocarcinoma of intestinal type was diagnosed based on the biopsy report, and patient was referred to the hospital for colectomy. In colonoscopy and biopsy, the polypoid mass was completely removed, and despite different sections of the whole specimen in the colectomy specimen, any mass was not found, while only one out of three identified lymph nodes were involved. In laboratory tests, CBC had anemia: (Hb: 10.8 mg/ dl), elevated CEA tumor marker (range: 18 ng/ml), and lipid profile disorder together with high cholesterol (300 mg/dl), indicating colon cancer manifestation.


2019 ◽  
Vol 49 ◽  
pp. 6-8
Author(s):  
Azmaiparashvili G. აზმაიფარაშვილი გ. ◽  
Tomadze G. თომაძე გ. ◽  
Megreladze A. მეგრელაძე ა.

Short bowel syndrome is characterized by malabsorption following extensive resection of the small bowel. It may occur after resection of more than 50% and is certain after resection of more than 70% of the small intestine, or if less than 100 cm of small bowel remains.  Successful postoperative management of short bowel syndrome has been discussed. Patient was operated because of cancer of hepatic flexure of large bowel with invasion in stomach, pancreas, retroperitoneal space, mesentery of small bowel. Right sided colectomy and excessive resection of small bowel with limphodissection was performed and only 80 cm of small bowel was left together with the left part of the colon. Ileotransversoanastomosis was performed. After the adequate course of chemotherapy and partial parenteral nutrition patient’s general condition became satisfactory. Patient started to gain weight. Adequate postoperative treatment determined postoperative period without surgical and nutritional complication.


BMJ ◽  
1946 ◽  
Vol 1 (4460) ◽  
pp. 988-988 ◽  
Author(s):  
C. F. J. Cropper
Keyword(s):  

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