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 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 Giant vascular malformation of the right colic flexure as a cause of abdominal pain

2020 ◽  
pp. 90-92
Author(s):  
E. A. Gallyamov ◽  
M. A. Agapov ◽  
N. V. Danilova ◽  
V. V. Kakotkin ◽  
P. G. Mal’kov
Keyword(s):  
Computed Tomography ◽  
Vascular Malformation ◽  
Laparoscopic Approach ◽  
Right Hemicolectomy ◽  
Wall Thickening ◽  
Ascending Colon ◽  
Contrast Enhanced ◽  
Venous Phase ◽  
Vascular Structures ◽  
The Right

A 31-year-old man admitted to clinic with complains of occasional pains in the right upper quadrant unrelated to the food. Results of laboratory tests were in the normal range. There were wall thickening of the ascending colon with sites of calcification located intramural according to abdominal contrast-enhanced multislice computed tomography. The above-mentioned structures accumulated contrast during a venous phase of computed tomography. A barium X-ray was performed, filling defects in right colon were detected but barium follow throughs was normal. Multiple dilated vascular structures of variable sizes l affecting the bowel submucosa in ascending colon for more than 10 cm were detected during the colonoscopy. The patient was diagnosed with hemangiomatosis of colon. Because of the high risk of massive large-bowel hemorrhage and malignization the laparoscopic right hemicolectomy was performed. Morfologic findings were interpreted as vascular malformation of colon. The patient has been activated fully on 1-st day after surgery, discharged on 5-th day in hospital. Gastrointestinal (GI) vascular malformation is an infrequent disorder of blood vessel formation characterized by existence of tumor-like vascular structures through the entire GI tract. Nowadays there is no single approach to the management of this group of diseases. Surgery is the only radical metod of the treatment of vascular malformation. The laparoscopic approach has substantional advantages in treatment of this infrequent group of diseases.

scholarly journals Foramen of Winslow hernia: an open approach

2021 ◽  
Vol 8 (4) ◽  
pp. 1312
Author(s):  
Muhammad F. Rosley ◽  
Senal Medagedara ◽  
Marius Jordaan
Keyword(s):  
Epigastric Pain ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Operative Management ◽  
Open Approach ◽  
Cross Sectional ◽  
Foramen Of Winslow ◽  
Internal Hernias ◽  
Preventative Measures ◽  
The Right

Foramen of Winslow hernia (FWH) are considered rare even among other internal hernias. It was first described in 1834 and historically had a mortality rate of close to 50%. With modern advancement and availability of cross-sectional imaging, this number has improved dramatically to 5%. Operative management is required for all patients which can be performed with either an open or laparoscopic approach. Preventative measures for recurrence remain controversial as no case of recurrence has been reported to date. We present a case study of a 62 years old woman who presented to the emergency department with severe epigastric pain and a CT scan confirming an FWH. She underwent urgent laparotomy and the hernia was easily reducible without need of intestinal resection. We opted to fixate the right colon and close the foramen of Winslow to prevent future recurrence. She recovered from her surgery well and was discharged home without any complications.

scholarly journals Pure laparoscopic unilateral nephrectomy for a patient with a polycystic horseshoe kidney

2014 ◽  
Vol 8 (11-12) ◽  
pp. 881 ◽  
Author(s):  
Shawn Dason ◽  
Christopher B Allard ◽  
Bobby Shayegan ◽  
Kevin Piercey
Keyword(s):  
Renal Transplantation ◽  
Autosomal Dominant ◽  
Iliac Fossa ◽  
Laparoscopic Approach ◽  
Horseshoe Kidney ◽  
Laparoscopic Nephrectomy ◽  
Polycystic Kidney ◽  
Large Size ◽  
Autosomal Dominant Polycystic Kidney ◽  
The Right

A 45-year-old female patient with autosomal dominant polycystic kidney disease (ADPKD) and a horseshoe kidney underwent right laparoscopic nephrectomy. The indication for nephrectomy was to create space within the right iliac fossa for renal transplantation. The operation proceeded as routine for laparoscopic nephrectomy for ADPKD, but was uniquely challenging due to the large size and extensive vasculature of the polycystic horseshoe kidney. In addition to documenting the feasibility of the pure laparoscopic approach for nephrectomy in patients with ADPKD and horseshoe kidney, this case highlights the abnormal location and vasculature encountered when operating on horseshoe kidneys.

scholarly journals Laparoscopic management of an ascending colon hernia through the foramen of Winslow

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Cyrille Buisset ◽  
Agathe Postillon ◽  
Sandrine Aziz ◽  
Florian Bilbault ◽  
Guillaume Hoch ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Internal Hernia ◽  
Preoperative Diagnosis ◽  
Clinical Presentation ◽  
Absorbable Suture ◽  
Ascending Colon ◽  
Foramen Of Winslow ◽  
Absorbable Sutures ◽  
The Right ◽  
Epigastric Abdominal Pain

Abstract Herniation through the foramen of Winslow is rare, with a non-specific clinical presentation and his diagnosis may be difficult. A 44-year-old female was admitted with an acute epigastric abdominal pain. A computed tomography showed an internal hernia of the colon in the lesser sac. Laparoscopic reduction of the herniated contents and the fixation of the ascending colon with several non-absorbable sutures were performed. Twenty months after surgery, the patient has not experienced any recurrence. Computed tomography helps practitioners to the preoperative diagnosis of herniation through the foramen of Winslow, to the viability of the herniated contents and presence of occlusion. In case of herniation through the foramen of Winslow favored by a mobile ascending colon with a misapposition of the right Told fascia, the fixation of the colon with a non-absorbable suture was safe and may prevent the risk of recurrent internal hernia and colonic volvulus.

scholarly journals A study on right iliac fossa mass

2017 ◽  
Vol 4 (10) ◽  
pp. 3292
Author(s):  
Anita Samraj ◽  
Sanjay Prakash J. ◽  
Muthukumaran G.
Keyword(s):  
Psoas Abscess ◽  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Contrast Enema ◽  
The Other ◽  
Histopathological Diagnosis ◽  
Hodgkins Lymphoma ◽  
Non Hodgkins Lymphoma ◽  
The Right ◽  
Appendicular Mass

Background: Patients with mass in the right iliac fossa may confront the surgeon, pediatrician or gynecologist. Thus, thorough understandings of the anatomy and pathological process that may occur within the abdomen are essential for an accurate diagnosis and plan of treatment. The objective of this study was to interpret aetiopathology, clinical presentation, differential diagnosis and management of mass in the right iliac fossa.Methods: A total of 60 cases with mass in the right iliac fossa (RIF) were included in the study. Investigations like colonoscopy and CT scan were done. All the cases underwent right hemicolectomy followed by chemotheraphy. Other cases like psoas abscess, non-hodgkins lymphoma, Meckels diverticulum and intussusception were diagnosed and treated.Results: During this study period, a total number of 36 cases of appendicular mass and 10 cases of appendicular abscess were encountered. In this study 10 cases of appendicular abscess were encountered and treated by extraperitoneal drainage, 4 cases of ileocaecal kochs were encountered. Patients presented with constitutional symptoms like pain, fever, weight loss etc. Right hemicolectomy was done, specimens after operative procedures were examined microscopically and histopathological diagnosis. 3 cases of carcinoma caecum and 3 cases of carcinoma ascending colon were seen. Contrast enema was done which showed filling defect and mucosal irregularities.Conclusions: This study showed that appendicular mass is the commonest pathology in right iliac fossa amongst all and conservative treatment followed by interval appendicectomy is the best mode of treatment. Carcinoma of the colon and ileocaecal tuberculosis is the other two common causes for mass in the right iliac fossa. These cases also carry a good prognosis, if properly diagnosed and treated. The other rare causes of mass in the right iliac fossa are intussusception, psoas abscess and Non Hodgkins lymphoma.

scholarly journals Secondary Abdominal Pregnancy: A Rare Presentation

2015 ◽  
Vol 7 (3) ◽  
pp. 243-244
Author(s):  
R Agarwal ◽  
E Sharma ◽  
R Khateja ◽  
A Suneja ◽  
A Sharma
Keyword(s):  
Pregnant Woman ◽  
South Asian ◽  
Iliac Fossa ◽  
Rare Event ◽  
Diagnostic Technique ◽  
Abdominal Pregnancy ◽  
Combine Approach ◽  
Vaginal Examination ◽  
Rare Presentation ◽  
The Right

ABSTRACT Background Abdominal pregnancy has been defined as an implantation in the peritoneal cavity, exclusive of tubal, ovarian or intraligamentary pregnancy which further classified in primary and secondary abdominal pregnancy. Abdominal pregnancy is a rare event but it represents a grave risk to the health of the pregnant woman. Case A 32 years old multigravida presented at 16 weeks of pregnancy with complaints of pain in right iliac fossa since 4 days. Vaginal examination revealed a 12 weeks size uterus with an right adenexal mass. Sonography showed intrauterine placentation with dead fetus lying outside the uterus in the right fornix. On laparotomy, diagnosis of secondary abdominal pregnancy made and managed accordingly. Conclusion A high suspicion of abdominal pregnancy is to be kept in obstetrician mind because of its various presentation. Early diagnosis and management is required in this lifethreatening condition. A combine approach of clinical as well as diagnostic technique is indicated. How to cite this article Sharma E, Khateja R, Agarwal R, Suneja A, Sharma A. Secondary Abdominal Pregnancy: A Rare Presentation. J South Asian Feder Obst Gynae 2015;7(3): 243-244.

scholarly journals Laparoscopic Repair of Morgagni Hernia Combined with Right Hemicolectomy for Bleeding Ascending Colon Carcinoma Lodged within the Chest: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Oluwatobi O Onafowokan ◽  
Kiran Khosa ◽  
Hugo Bonatti
Keyword(s):  
Colon Cancer ◽  
Case Report ◽  
Hernia Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Rare Condition ◽  
Right Hemicolectomy ◽  
Morgagni Hernia ◽  
The Right ◽  
Diaphragmatic Hernias

Background. Morgagni hernias are rare in adults and may be asymptomatic but, nevertheless, require surgical repair, with laparoscopy offering an excellent option. The colon dislodged into the chest through diaphragmatic hernias may be affected by various disorders, including malignancies. Case Report. A 70-year-old obese male presented with fatigue and shortness of breath. CT scan showed the right colon lodged in the chest through a Morgagni hernia. He was anaemic, and colonoscopy revealed a colon cancer. He underwent combined laparoscopic hernia repair with bioabsorbable mesh and right hemicolectomy. Recovery was uneventful, but the patient died 5 months later from chemotherapy-associated cardiac failure. Literature review revealed eight similar published cases, and including ours, there were seven Morgagni hernias, one traumatic hernia, and one Bochdalek hernia. Median age of the five men and four women was 66 (range 49-85) years. Surgical approach was thoracotomy (2), laparotomy (5), and laparoscopy (2). Conclusion. Outcome of the rare condition is determined by the course of the colon cancer. Hernia repair was successful in ours and all other published cases. A combined laparoscopic approach can be safely done.

scholarly journals A Pink Herring in the Colon: A Case Report of Eosinophilic Colitis Masking Invasive Adenocarcinoma of the Colon

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
David Malcolm Milne ◽  
Jason Rattan ◽  
Alyssa Muddeen ◽  
Amrit A. Rambhajan
Keyword(s):  
Colon Cancer ◽  
Weight Loss ◽  
Iliac Fossa ◽  
Fluid Collection ◽  
Right Hemicolectomy ◽  
Subsequent Treatment ◽  
Invasive Adenocarcinoma ◽  
Lower Quadrant ◽  
Eosinophilic Colitis ◽  
The Right

Eosinophilic colitis is an inflammatory condition in which the wall of the colon becomes infiltrated by eosinophils which stain densely pink on microscopy. It is an uncommon clinical entity which has a long list of differential diagnoses. We present a case of a patient whose biopsy at colonoscopy revealed eosinophilic colitis which led to a delay in the diagnosis and subsequent treatment of colon cancer. A 35-year-old male presented with a six-week history of right lower quadrant abdominal pain associated with diarrhoea and weight loss. Colonoscopy showed an inflamed cecum; computed tomography revealed a small ascitic fluid collection in the right iliac fossa. Biopsy showed eosinophilic colitis, and he was treated conservatively with albendazole and mesalamine. The patient failed to improve over the following month with continued weight loss. A repeat CT scan showed a right iliac fossa mass. A right hemicolectomy was performed with histopathology from the specimen showing mucinous adenocarcinoma. Eosinophilic colitis can mask colon cancer and should be considered a diagnosis of exclusion.

Appendiceal Mucocele of Mucinous Cystadenocarcinoma with a Cutaneous Fistula

2002 ◽  
Vol 30 (4) ◽  
pp. 452-456 ◽  
Author(s):  
A Nakao ◽  
S Sato ◽  
A Nakashima ◽  
A Nabeyama ◽  
N Tanaka
Keyword(s):  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Cystic Mass ◽  
Japanese Woman ◽  
Mucinous Cystadenocarcinoma ◽  
Appendiceal Mucocele ◽  
Old Japanese ◽  
Well Differentiated ◽  
The Right ◽  
Skin Fistula

We report a novel case of cystadenocarcinoma forming an appendiceal mucocele with development of a skin fistula. The patient was a 75-year-old Japanese woman who originally presented with a skin ulcer on the right flank (inferior to the ribs and superior to the iliac bone) with mucus discharge. The serum concentration of carcinoembryonal antigen was elevated (57.4 ng/ml). Ultrasonography and computed tomography demonstrated a cystic mass with septations in the right iliac fossa. Fistulography from the skin ulceration showed a communication via the fistula to the caecum. A right hemicolectomy and enbloc resection of the skin fistula was performed. The histological findings revealed a well-differentiated mucinous cystadenocarcinoma of the appendix. The patient has been alive for 7 years following surgery without any sign of recurrence. This report is of interest as it demonstrates that tumour rupture to the extraperitoneal space could result in a good outcome by preventing the development of pseudomyxoma peritonei.

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