scholarly journals Fecal Scrotal Abscess Secondary to Spontaneous Retroperitoneal Perforation of Ascending Colon

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Akshay Bahadur ◽  
Nirmala Singh ◽  
Mayank Kashmira ◽  
Ashish Shukla ◽  
Vikas Gupta ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Iliac Fossa ◽  
Abdominal Distension ◽  
Posterior Wall ◽  
Retroperitoneal Abscess ◽  
Bowel Loop ◽  
Ascending Colon ◽  
Retroperitoneal Perforation ◽  
The Right ◽  
Spread Of Infection

Introduction. Fecal abscess or enterocutaneous fistulas of the scrotum are rare and are invariably the result of incarcerated bowel loop in inguinal hernia. Spontaneous perforation of the colon (SPC) having no definite cause is also rare. Much rarer is posterior colonic perforations causing an extensively large retroperitoneal abscess. Similarly, spread of retroperitoneal abscess to the thigh or scrotum has rarely been reported. We report a case of spontaneous posterior perforation of ascending colon resulting in large retroperitoneal abscess eventually causing scrotal abscess, which resolved on conservative treatment and drainage of the scrotal fecal abscess. Case Presentation. A 20-year-old male presented with gradually increasing noncolicky pain right side abdomen with nonprojectile vomiting, obstipation, and progressive abdominal distension. Clinically, the abdomen was tender with guarding over the right side with signs of inflammation on the right side back with no associated hernia. On conservative treatment, he was gradually improved but developed right side scrotal abscess a week later. CT abdomen showed a large retroperitoneal collection having multiple internal air lucencies, displacing ascending colon and caecum medically with discontinuity in the posterior wall of ascending colon. The large retroperitoneal collection was extending from right pararenal and posterior perihepatic soft tissue planes to the right iliac fossa and thigh. On drainage of the scrotal abscess, about 350 ml of fecal contents was evacuated. The patient gradually recovered and was discharged on conservative treatment with an uneventful 4-year follow-up. Conclusion. Diagnosis of retroperitoneal perforation of the colon is often delayed due to the absence of peritoneal irritation. An extensively large retroperitoneal abscess may spread the infection to the scrotum and thigh due to extreme pressure, possibly by dissecting away the transversalis fascia through a deep ring along the side of the spermatic cord. Timely performed CT/MRI can avoid delay in the diagnosis of retroperitoneal abscess and further spread of infection.

scholarly journals COEXISTENCE OF TUBERCULOSIS AND ADENOCARCINOMA OF THE COLON

2003 ◽  
Vol 42 (145) ◽  
pp. 39-41
Author(s):  
Yogendra Singh ◽  
G Sayami ◽  
M Khakurel
Keyword(s):  
Histopathological Examination ◽  
Psoas Abscess ◽  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Ascending Colon ◽  
Colonic Tuberculosis ◽  
Adenocarcinoma Of The Colon ◽  
Well Differentiated ◽  
The Right

ABSTRACTA 60-years-old, male patient presented with a-tender swelling in the right iliac fossa with right hip flexiondeformity suggesting of psoas abscess. Following emergency drainage of faeculant pus, the general conditionof the patient improved. The barium enema showed leaking ascending colonic ulcer and colonoscopicexamination revealed nonspecific ulcerative lesion in the ascending colon. Repeat investigations were alsonon-conclusive except there was a stricture at the ascending colon on colonoscopy. A second operationshowed that there was a huge mass of terminal ileum, cecum and ascending colon and perforation of ascendingcolonic ulcer most likely carcinoma. Right hemicolectomy was performed with uneventful postoperativeperiod. Histopathological examination revealed well differentiated adenocarcinoma limited to the musclelayer of the ascending colon and features suggestive of colonic tuberculosis at the same site. Antituberculartreatment was completed with regular follow-up and monitoring on CEA level. Patient has been doing well3 years postoperatively. Although rare, the coexistence of colonic tuberculosis with carcinoma may occur. Adefinitive diagnosis can be established only by histological examination.Key Words: Colonic tuberculosis, Adenocarcinoma, Histology.

scholarly journals Endoscopic Submucosal Dissection of Pseudo-polyps in the Right Colon Using a Flexible Grasper With Articulating Distal Tip and Elbow-Like Bending

2021 ◽  
Author(s):  
Shinya Urakawa ◽  
Teijiro Hirashita ◽  
Yuka Hirashita ◽  
Lea Lowenfeld ◽  
Krishna Gurram ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
3D Model ◽  
Posterior Wall ◽  
Ascending Colon ◽  
Procedure Time ◽  
Right Colon ◽  
Submucosal Dissection ◽  
Descending Colon ◽  
The Right ◽  
Surgical Platform

Abstract Endoscopic submucosal dissection (ESD) is challenging in the right colon. Traction devices can make it technically easier. In this study, we evaluated a flexible grasper with articulating tip and elbow-like bending (IgE) through a double-balloon surgical platform (DESP), compared with an earlier generation grasper without elbow-like bending (Ig). The reach of Ig/IgE was investigated at eight locations using a synthetic colon within a 3D model. Using a fresh porcine colorectum, 4 cm pseudo-polyps were created at the posterior wall of the ascending colon. Fifty-four ESD procedures were performed using three techniques: standard ESD (STD), ESD using Ig (DESP+Ig), and ESD using IgE (DESP+IgE). IgE was able to reach the full circumference at all the locations, whereas the medial walls proximal to the descending colon were out of Ig’s reach. Compared with the STD, both DESP+Ig and DESP+IgE showed significantly shorter procedure time (STD vs. DESP+Ig vs. DESP+IgE = median 48.9 min vs. 38.6 vs. 29.9) and fewer injuries (1.5 vs. 0 vs. 0). Moreover, the DESP+IgE had a shorter procedure time than the DESP+Ig (p=0.0025). The IgE with DESP increased instrument reach compared to Ig, and likely represented a traction tool for excision of large pseudo-polyps in the right colon.

scholarly journals Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinya Urakawa ◽  
Teijiro Hirashita ◽  
Yuka Hirashita ◽  
Lea Lowenfeld ◽  
Krishna C. Gurram ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
3D Model ◽  
Posterior Wall ◽  
Ascending Colon ◽  
Procedure Time ◽  
Right Colon ◽  
Preclinical Trial ◽  
Descending Colon ◽  
The Right ◽  
Surgical Platform

AbstractEndoscopic submucosal dissection (ESD) is challenging in the right colon. Traction devices can make it technically easier. In this study, we evaluated a flexible grasper with articulating tip and elbow-like bending (IgE) through a double-balloon surgical platform (DESP), compared with an earlier generation grasper without elbow-like bending (Ig). The reach of Ig/IgE was investigated at eight locations using a synthetic colon within a 3D model. Using a fresh porcine colorectum, 4 cm pseudo-polyps were created at the posterior wall of the ascending colon. Fifty-four ESD procedures were performed using three techniques: standard ESD (STD), ESD using Ig (DESP + Ig), and ESD using IgE (DESP + IgE). IgE was able to reach the full circumference at all the locations, whereas the medial walls proximal to the descending colon were out of Ig’s reach. Compared with the STD, both DESP + Ig and DESP + IgE showed significantly shorter procedure time (STD vs. DESP + Ig vs. DESP + IgE = median 48.9 min vs. 38.6 vs. 29.9) and fewer injuries (1.5 vs. 0 vs. 0). Moreover, the DESP + IgE had a shorter procedure time than the DESP + Ig (p = 0.0025). The IgE with DESP increased instrument reach compared to Ig, and likely represented a traction tool for excision of large pseudo-polyps in the right colon.

scholarly journals Herniation of the caecum and ascending colon through the foramen of Winslow: a case report and review

2020 ◽  
Vol 102 (2) ◽  
pp. e39-e41
Author(s):  
M Sammut ◽  
C Barben
Keyword(s):  
Epigastric Pain ◽  
Iliac Fossa ◽  
Rare Event ◽  
Laparoscopic Approach ◽  
Right Hemicolectomy ◽  
Ascending Colon ◽  
Midline Laparotomy ◽  
Foramen Of Winslow ◽  
Handsewn Anastomosis ◽  
The Right

Approximately 5% of intestinal obstruction cases are caused by internal herniation. Caecal herniation through the foramen of Winslow is considered a rare event. The management of caecal herniation remains challenging due to the lack of literature highlighting this pathology. A 66-year-old woman was admitted with a 24-hour history of epigastric pain radiating to the back. The pain was associated with nausea and vomiting of gastric contents. On examination, the abdomen was soft with mild tenderness but no signs of peritonism or distension. The abdominal x-ray and a computed tomography were in keeping with caecal volvulus and confirmed that the caecum was not in the right iliac fossa. In a midline laparotomy procedure, the ileum, caecum and ascending colon were noted to be herniating into the foramen of Winslow. A right hemicolectomy with a handsewn anastomosis was performed. The foramen of Winslow was not closed. No postoperative complications occurred. A literature review showed a lack of similar cases with no agreed management consensus. The laparotomy approach is comparable to the laparoscopic approach and no caecal herniation recurrence after open/laparoscopic surgical procedures were identified. Awareness of caecal herniation allows early diagnosis and timely surgical management is needed in prevent patient morbidity and mortality.

scholarly journals T cell/histiocyte rich large B cell lymphoma of ascending colon: a rare entity

2020 ◽  
Vol 7 (3) ◽  
pp. 918
Author(s):  
Vinita Agrawal ◽  
Mithlesh Bhargav ◽  
Supriya Sharma ◽  
Vaibhav Raj Gopal
Keyword(s):  
T Cell ◽  
B Cell ◽  
Cell Lymphoma ◽  
Iliac Fossa ◽  
B Cell Lymphoma ◽  
Ascending Colon ◽  
Large B Cell Lymphoma ◽  
Loss Of Weight ◽  
The Right ◽  
Large B Cell

Colonic T cell/histiocyte rich large B cell lymphoma (THRLBCL) is a very unusual occurrence never described before. A 41-year anaemic male presented with loss of weight and appetite for 7 months and fever with Malena for 1 month. Abdominal examination revealed a 4×6 cm retroperitoneal lump in the right iliac fossa. Radiological investigations (USG and CECT whole abdomen) reported an asymmetrical ill-defined growth in ascending colon and caecum with loco-regional lymphadenopathy. Surgical exploration revealed an ascending colon mass with retroperitoneal lymphadenopathy. Right hemi-colectomy with end ileostomy was done and specimen was sent for histopathology which diagnosed it to be a case of THRLBCL of colon. Patient was followed up after 2 weeks and was planned for chemotherapy.

scholarly journals Retroperitoneal Abscess Simulating Abdominal Mass in a Child

2017 ◽  
Vol 8 (5) ◽  
pp. 32
Author(s):  
Rahul Gupta
Keyword(s):  
Abdominal Pain ◽  
Peritoneal Cavity ◽  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Abdominal Mass ◽  
Hepatic Flexure ◽  
Retroperitoneal Abscess ◽  
Ascending Colon ◽  
Retroperitoneal Mass ◽  
Abdominal Masses

Retroperitoneal abscess may simulate other abdominal masses. A 2-year-old girl presented with abdominal pain and lump in right iliac fossa for the last one week. Investigations revealed a mass extending from pelvis up to right sub-hepatic region. Diagnostic laparoscopy revealed an unremarkable peritoneal cavity, except that ascending colon up to hepatic flexure was elevated suggestive of retroperitoneal mass. A small flank incision was then made and abscess was drained.

OSTEOMYELITIS KRONIS MANDIBULA PASCA EKSTRAKSI GIGI DISERTAI BELL’S PALSY

2019 ◽  
Vol 6 ◽  
pp. 52
Author(s):  
Yayun Siti Rochmah
Keyword(s):  
Facial Nerve ◽  
Panoramic Radiograph ◽  
Surrounding Tissue ◽  
Facial Nerve Paralysis ◽  
Muscle Paralysis ◽  
Nerve Paralysis ◽  
The Right ◽  
Spread Of Infection ◽  
Nerve System ◽  
Intravenous Ketorolac

Background: Chronic osteomyelitis mandibula is one of the complications from dental extraction. Inadequate wound handling can have an impact on the spread of infection in the surrounding tissue like nerve which results in facial nerve paralysis. The purpose is to present a rare case that facilitative nerve paralysis as a result of the spread of osteomyelitis infectionCase Management: A 69 years old woman with chief complains numbness onher lips accompanied by pus out beside the lower teeth. No sistemic disease. Panoramic radiograph showed abnormal bone-like sequester. Extraoral examination appeared the bluish color on the right cheek and there was right facial muscle paralysis. Debridement, sequesterectomy by general anesthesia and medication using ceftriaxone intravenous, ketorolac injection, multivitamin, and corticosteroid, physiotherapy for facial nerve paralyze, also.Discussion: Pathogenesis mandibular osteomyelitis involves contiguous spreadfrom an odontogenic focus infection. The bacteria produce an exotoxin, which, while unable to cross the blood-brain barrier, can have deleterious effects on thePeripheral Nerve System (Fasialis Nerve) in up to 75% of cases, with the severity of presentation correlating with the severity of the infection.Conclusion: Chronic mandibular osteomyelitis can spread the infection to around another anatomy oral cavity like facials nerves.

Mitral Re-Repair and Right Coronary Fistula Closure Advantage of Minimally Invasive Approach

2010 ◽  
Vol 5 (6) ◽  
pp. 456-459 ◽  
Author(s):  
Vincenzo Giordano ◽  
Jan G. Grandjean
Keyword(s):  
Mitral Valve ◽  
Right Atrium ◽  
Mild Hypothermia ◽  
Posterior Wall ◽  
Coronary Arteriography ◽  
Coronary Fistula ◽  
Invasive Approach ◽  
Concomitant Procedure ◽  
Echocardiographic Images ◽  
The Right

A 51-year-old man developed severe mitral regurgitation 10 years after previous mitral valve repair; the echocardiographic images showed a remarkable eccentric jet toward posterior wall of left atrium associated with a high degree of pulmonary vein retrograde flow. The coronary arteriography pointed out no pathologic lesions but a coronary fistula from the proximal right coronary to the right atrium. The standard approach was avoided, and a right anterolateral minithoracotomy was chosen, providing an excellent view. Under cardiopulmonary bypass and mild hypothermia, the mitral valve was re-repaired, and a new ring was implanted. After aortic cross-clamp release, the right coronary fistula was closed through the right atrium. The postoperative course was uneventful, and the patient was discharged on the fourth postoperative day. In such a high-risk reintervention and concomitant procedure, we think that this different approach may represent a feasible and reliable alternative.

scholarly journals Late presentation of extrauterine adenomyomas after laparoscopic morcellation at hysterectomy: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammed Nagdi Zaki ◽  
Aafia Mohammed Farooq Gheewale ◽  
Nada Ibrahim ◽  
Ibrahim Abd Elrahman
Keyword(s):  
Case Report ◽  
Transvaginal Ultrasound ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
Laparoscopic Hysterectomy ◽  
Pathology Report ◽  
Presacral Space ◽  
Gnrh Analogue ◽  
Power Morcellation ◽  
The Right

Abstract Background An adenomyoma is a well circumscribed form of adenomyosis and can be located within the myometrium, in the endometrium as a polyp, or extrauterine with the last being the rarest presentation amongst the three. With the ongoing advancement in gynecological surgery, the use of electromechanical morcellators have made the removal of large and dense specimens possible with minimally invasive techniques. However, it has also caused an increase in complications which were previously rare. Whilst the tissue is being grinded within the abdominal cavity, residual tissue can spread and remain inside, allowing for implantation to occur and thereby giving rise to recurrence of uterine tissue as a new late postoperative complication. Case presentation A 45-year-old woman presented with worsening constipation and right iliac fossa pain. Her past surgical history consists of laparoscopic supra-cervical hysterectomy that was indicated due to uterine fibroids. Computerized tomography and magnetic resonance imaging were done, which showed an irregular lobulated heterogeneous mass seen in the presacral space to the right, located on the right lateral aspect of the recto-sigmoid, measuring 4.5 × 4.3 × 4.3 cm in size. A transvaginal ultrasound revealed a cyst in the left ovary. The patient had a treatment course over several months that included Dienogest (progestin) and Goserelin (GnRH analogue) with add-back therapy. In line with the declining response to medications, the patient was advised for a laparoscopic ovarian cystectomy. During the surgery, an additional lesion was found as a suspected fibroid and the left ovarian cyst was identified as pockets of peritoneal fluid which was sent for cytology. The surgical pathology report confirmed adenomyosis in both specimens, namely the right mass and the initially suspected fibroid. Conclusion In this case report, we showcase a rare occurrence of an extrauterine adenomyoma presenting two years post laparoscopic morcellation at hysterectomy. This poses questions regarding the benefits versus risks of power morcellation in laparoscopic hysterectomy.

scholarly journals Ovarian epithelioid angiosarcoma complicating pregnancy: a case report and review of the literature

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110196
Author(s):  
Xiaotong Peng ◽  
Zhi Duan ◽  
Hongling Yin ◽  
Furong Dai ◽  
Huining Liu
Keyword(s):  
Adverse Events ◽  
Soft Tissues ◽  
Malignant Tumors ◽  
Cystic Teratoma ◽  
Abdominal Distension ◽  
Epithelioid Angiosarcoma ◽  
History Of ◽  
New Ideas ◽  
The Right ◽  
Clinical Awareness

Epithelioid angiosarcoma is a rare and highly aggressive soft tissue angiosarcoma most commonly arising in the deep soft tissues. Given that abundant vascular cavities anastomose with each other, most angiosarcomas prone to metastasis recur quickly, and the overall prognosis is poor. We report a 25-year-old woman at 24 weeks’ gestation who presented with a 1-month history of abdominal distension. Ultrasonography suggested a mass in the right adnexa, and she underwent two operations owing to uncontrolled intraperitoneal bleeding with progressive anemia. The right ovarian tumor and right adnexa were removed successively. Biopsy yielded a diagnosis of primary epithelioid angiosarcoma with mature cystic teratoma. The patient died from uncontrolled progressive bleeding 1 week after the second operation. This case revealed that epithelial angiosarcoma is a highly malignant endothelial cell tumor. The results of surgery and chemoradiotherapy tend to be poor, and the recurrence rate is high. The purpose of this study is to raise clinical awareness of epithelial angiosarcoma and its adverse events and to provide new ideas for the treatment of these adverse events. Immunohistochemical staining of pathological specimens can facilitate diagnosis. Pregnancy with malignant tumors may lead to rapid disease progression, extensive lesions, and a poor prognosis.

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