scholarly journals Laparoscopic approach of excision of anterior abdominal wall actinomycosis

2021 ◽  
Vol 8 (2) ◽  
pp. 733
Author(s):  
Satkunan Mark ◽  
Mohd Firdaus ◽  
Mohd Muselim ◽  
Lewellyn Rajakumar
Keyword(s):  
Abdominal Wall ◽  
Sigmoid Colon ◽  
Anterior Abdominal Wall ◽  
Iliac Fossa ◽  
Abdominal Mass ◽  
Laparoscopic Approach ◽  
Open Approach ◽  
En Bloc ◽  
Left Iliac Fossa ◽  
Laparoscopic Excision

Actinomycosis of the abdominal wall is a rare disease. While most of the reported cases are women, we present a 42-year-old male with an abdominal mass for 4 months. Clinical examination of the abdomen revealed a well circumscribed mass in the left iliac fossa. CT abdomen showed an anterior abdominal wall mass with infiltration to the sigmoid colon however colonoscopy ruled out intraluminal origin. In contrast to traditional open approach, a laparoscopic approach was done. The abdominal wall tumour and sigmoid colon was resected en- bloc and continuity restored extra- corporeally through a small incision. Histopathology of the specimen reported an abdominal wall actinomycosis and patient was discharged with antibiotics. Laparoscopic approach was successful as the tumour was small. We therefore conclude that an initial laparoscopic assessment can be advocated and a laparoscopic excision is always possible if the features are favourable.  

Laparoscopic removal of mesh migrating into the sigmoid colon after totally extraperitoneal (TEP) laparoscopic inguinal hernia repair with positive faecal occult blood test

2021 ◽  
Vol 14 (2) ◽  
pp. e237167
Author(s):  
Sujin Gang ◽  
Min Jung Kim ◽  
Ji Won Park ◽  
Seung-Bum Ryoo
Keyword(s):  
Inguinal Hernia ◽  
Sigmoid Colon ◽  
Blood Test ◽  
Laparoscopic Approach ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Open Approach ◽  
Occult Blood Test ◽  
Totally Extraperitoneal ◽  
Abdominal Approach

A 76-year-old man was referred to our clinic after a foreign body seen in his sigmoid colon during a colonoscopy. He had undergone three operations for a left inguinal hernia within the previous 8 years, and the first procedure was a laparoscopic totally extraperitoneal approach. Four years later, removal of migrated and infected mesh was conducted by open approach. He then had a positive stool occult blood test for routine check-up 4 years after the remnant mesh removal. An ill-defined lesion was identified on colonoscopy. CT revealed a 2.7 cm diameter enhancing lesion in the sigmoid colon. Laparoscopic sigmoidectomy was performed, and remnant mesh fragment was found in the sigmoid colon and removed. The migrated mesh could not be wholly removed by open abdominal approach and the remnant mesh fragment migrated to sigmoid colon. It suggests the importance of a laparoscopic approach to remove the entire mesh.

scholarly journals Laparoscopic Cholecystectomy in the Presence of Lumboperitoneal Shunt

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Alexandros Charalabopoulos ◽  
Abraham J. Botha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Gallstone Disease ◽  
Laparoscopic Approach ◽  
Review Of The Literature ◽  
Nerve Stimulator ◽  
Occipital Nerve ◽  
Lumboperitoneal Shunt

Laparoscopic cholecystectomy remains the mainstay of treatment in patients with gallstone disease. Nowadays more than ever before, patients present with more comorbidities and entities that make the laparoscopic approach composite. One of these is the presence of lumboperitoneal (LP) shunts. Herein, we describe a case of successful laparoscopic cholecystectomy in a patient with an LP shunt and an occipital nerve stimulator in the anterior abdominal wall. We describe alterations in technique, aiming at surgeons that perform laparoscopic cholecystectomies with useful tips in order to successfully deliver the operation. A brief review of the literature in the current subject is also given.

scholarly journals Recurrent liver hydatid cyst and port site hydatid cyst in anterior abdominal wall in operated case of laparoscopic cystostomy for liver hydatid cyst: a rare complication

2021 ◽  
Vol 8 (11) ◽  
pp. 3495
Author(s):  
Swamy P. T. ◽  
Jayendra G. Vagadia ◽  
Jatin G. Bhatt ◽  
Jignesh P. Dave
Keyword(s):  
Hydatid Cyst ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Rare Complication ◽  
Treatment Options ◽  
Laparoscopic Approach ◽  
Public Health Problem ◽  
Animal Husbandry ◽  
Port Site ◽  
Liver Hydatid Cyst

Hydatid disease, or echinococcosis, is a widespread zoonotic parasitic disease caused by a tapeworm that continues to be a clinical and public health problem worldwide, especially in areas where animal husbandry and subsistence farming form an integral part of community life. Location of cyst in different organs of body changes the diagnostic and therapeutic management of the cyst.  Four treatment options are currently available: radical surgery, conservative surgery, puncture-aspiration-injection-respiration (PAIR), and antiparasitic medical treatment. Surgery is gold standard for liver hydatid cyst and can be done by open/laparoscopic approach. We are reporting a case of recurrence of liver hydatid cyst with port site anterior abdominal wall hydatid cyst in a 40-year-old female patient operated previously for laparoscopic liver hydatid cystectomy. ­­­Port site hydatid cyst is a rare complication after laparoscopic hydatid cystotomy, but can occur due to lodgement of scolices at port site while removing daughter cyst at port site of laparoscopy.

scholarly journals 559 One Mesenteric Defect, Two Segments of Colon, A Number of Surgical Strategies! A Rare Case of An Internal Hernia Causing Bowel Ischemia

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Devani ◽  
N Al-Saadi ◽  
D Bowrey
Keyword(s):  
Small Bowel ◽  
Sigmoid Colon ◽  
Internal Hernia ◽  
Laparoscopic Approach ◽  
Signs And Symptoms ◽  
High Morbidity ◽  
Sigmoid Colectomy ◽  
Open Approach ◽  
Mesenteric Defect ◽  
Surgical Strategies

Abstract Internal hernias due to mesenteric defects are a rare cause of bowel obstruction, but once present their complications are associated with a high morbidity and mortality. We present the case of a 24-year-old patient who presented to the emergency department with signs and symptoms of an acute abdomen. Following surgical review, taking into consideration the patient’s clinical, biochemical, and radiological findings, the patient was taken for immediate emergency surgical exploration. A laparoscopic approach was initially taken, which revealed dilated and ischemic colon, and therefore an open approach was then adopted. Operative findings included a very mobile caecum and proximal ascending colon which had herniated through a defect in the small bowel mesentery, the sigmoid colon had subsequently become incarcerated by the caecum and small bowel too. Both the ascending and sigmoid colon had become ischemic. A number of surgical strategies were considered, and given the patients age it was decided to preserve as much normal bowel as possible. Thus, a right hemi- and sigmoid colectomy were performed with an ileo-transverse anastomosis and formation of an end colostomy. In this case, radiological diagnosis pointed to a suspicion of an internal hernia, and operative diagnosis highlighted a rare mesenteric defect causing herniation and subsequent ischemia. Relying on the patient’s clinical condition and an early decision for surgical intervention resulted in a positive outcome for outpatient. The patient made a good recovery following the bowel preserving surgery.

Pylephlebitis Complicating Concurrent Sigmoid Endometriosis and Diverticulosis: A Case Report

2011 ◽  
Vol 3 (2) ◽  
pp. 120-123
Author(s):  
Alastair J. Hayes ◽  
Reddivari AK. Reddy ◽  
Beate Haugk ◽  
Hugh J. Gallagher
Keyword(s):  
Sigmoid Colon ◽  
Iliac Fossa ◽  
Colonic Obstruction ◽  
Liver Perfusion ◽  
Exploratory Laparotomy ◽  
Portal System ◽  
Fistula Formation ◽  
Inferior Mesenteric Vein ◽  
Intestinal Endometriosis ◽  
Left Iliac Fossa

Purpose To explain an unusually severe presentation of concurrent sigmoid diverticulosis and endometriosis. Intestinal endometriosis can be complicated by colonic obstruction, perforation, fistula formation, and sepsis. Suppurative thrombosis of the portal system (pylephlebitis) complicating intestinal endometriosis has not been previously reported. Methods A previously fit and well 44-year-old woman presented with a two-day history of severe, intermittent left iliac fossa pain and loose, brown stools. CT scan revealed thickening of the sigmoid colon and inferior mesenteric and intra-hepatic vein thrombosis with patchy liver perfusion. Conservative management failed and an exploratory laparotomy showed a sigmoid inflammatory phlegmon. The inferior mesenteric vein containing pus and thrombus was excised together with the sigmoid mass. Results Histology revealed sigmoid colonic diverticulosis and endometriosis associated with extensive subserosal abscess formation. Widespread suppurative necrotizing venulitis with partial thrombosis of mesenteric veins was found. Literature review revealed that endometriotic cells produce a variety of pro-inflammatory mediators. Conclusions We postulate that endometriotic tissue within the diverticular sigmoid colon triggered an inflammatory cascade, leading to bacterial translocation and pylephlebitis.

scholarly journals Delay in diagnosis and lessons learnt from a case of abdominal wall abscess caused by fishbone perforation

2015 ◽  
Vol 97 (3) ◽  
pp. e39-e42 ◽  
Author(s):  
A Hakeem ◽  
V Shanmugam ◽  
K Badrinath ◽  
M Dube ◽  
P Panto
Keyword(s):  
Small Bowel ◽  
Abdominal Wall ◽  
Close Contact ◽  
Iliac Fossa ◽  
Clinical Problem ◽  
Left Iliac Fossa ◽  
Delay In Diagnosis ◽  
History Of ◽  
Made In

Complications following foreign body (FB) ingestion are an uncommon clinical problem. A 59-year-old man presented with a 4-week history of left iliac fossa pain and 1 episode of dark red blood mixed with stools. Inflammatory markers were elevated, and computed tomography (CT) of the abdomen and pelvis showed an ill defined abdominal wall inflammatory collection in close contact with the small bowel loops. He was treated with antibiotics, and follow-up CT, colonoscopy and small bowel enema were mostly unremarkable. The patient presented again ten months later with left iliac fossa cellulitis and fever. Multiplanar CT (the patient’s fourth scan) demonstrated a 10cm abdominal wall collection with a linear hyperdense structure in the collection. The radiologists suspected a FB and on close scrutiny of the previous scans, they noted it to have been present on all of them. A targeted incision led to the removal of a 3cm fishbone from the collection. This case highlights the need to consider the possibility of a FB being the underlying cause in any unexplained intra-abdominal or abdominal wall inflammatory process so that the diagnosis is made in a timely manner.

scholarly journals Necrotizing fasciitis, poor hygiene and negligence in obese patients

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Dan Dumitrescu ◽  
Victor Dumitrescu ◽  
Costel Savlovschi
Keyword(s):  
Necrotizing Fasciitis ◽  
Abdominal Wall ◽  
Economic Status ◽  
Iliac Fossa ◽  
The Body ◽  
Large Area ◽  
Left Iliac Fossa ◽  
Protective Function ◽  
Surgical Interventions ◽  
Surgical History

The Tegument, the body's largest organ, also fulfills the protective function by preventing the pathogens from penetrating into the body. The barrier, once overcome, opens the gate to serious illnesses with varying degrees of severity. We present the case of an obese patient aged 63, BMI 40, admitted to emergency service for necrotizing fasciitis in the abdominal wall. Anamnesis and general clinical examination highlight the presence of a large area of necrosis in the lower abdominal wall, affecting the iliac fossa, the hypogastric region and the left iliac fossa, lack of substance at this level, limited supraaponvrotic, with multiple sepsis, isolated tissue areas granulation, anfractum edges, suggestive aspect for necrotizing fasciitis. Serious surgical interventions have been carried out, with the aim of broad, digital and instrumental debridement, the important lavage of the wound with hydrogen peroxide and betadine and antibiotic treatment according to the antibiogram. Subsequently, dressings were applied with negative pressure, with development of granulation tissue in the wound and in the end was chosen for secondary suture with favorable outcome and discharge from the hospital 33 days after admission. Precarius socio-economic status, poor hygiene in an obese, careless patient, without identifying other causes like diabetes or surgical history, have led to the development of a multilingual, life-threatening condition. Serious surgical attitude and postoperative care have led to a medical success, although burdened by significant costs, which could have been avoided with minimal effort especially from the patient.

scholarly journals An unusual case of right iliac fossa lump-spigelian hernia: a case report

2021 ◽  
Vol 9 (1) ◽  
pp. 239
Author(s):  
Birma Ram ◽  
Manoj Gopinath ◽  
Saroj Chaudhary ◽  
Desymol Johnson
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Abdominal Wall ◽  
Preoperative Diagnosis ◽  
Unusual Case ◽  
Surgical Repair ◽  
Anterior Abdominal Wall ◽  
Iliac Fossa ◽  
Spigelian Hernia

Spigelian hernia is a relatively uncommon hernia of anterior abdominal wall, occurring in different anatomical tissue planes. It is a variant of inter-parietal hernia. Preoperative diagnosis of obstructed inter-parietal hernia is based on imaging. Once correctly diagnosed it is easily amenable to surgical repair. We present a case of Spigelian hernia presenting as right iliac fossa lump with features of small bowel obstruction.

scholarly journals Case Report: Sigmoid volvulus associated with a torsion of an ovarian cyst

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 917
Author(s):  
Hakim Zenaidi ◽  
Imen Ben Ismail ◽  
Kamel Karma ◽  
Fatma Rekik ◽  
Fatma Khanchel ◽  
...  
Keyword(s):  
Sigmoid Colon ◽  
Ovarian Cyst ◽  
Iliac Fossa ◽  
Pelvic Mass ◽  
Sigmoid Volvulus ◽  
Emergency Laparotomy ◽  
Sigmoid Colectomy ◽  
Adnexal Torsion ◽  
Left Iliac Fossa ◽  
Fecal Matter

Sigmoid volvulus is a life-threatening condition rarely seen in young adults. However, adnexal torsion is one of the top causes of gynecological emergencies, with prevalence increasing with the presence of an ovarian cyst. The association of sigmoid volvulus and adnexal torsion is exceptional. We report the case of a 33-year-old woman who presented to the emergency department for abdominal pain evolving for six hours, associated with gas and fecal matter obstruction. Clinical examination showed a restless patient with tachycardia and distended abdomen with severe tenderness in the left iliac fossa. A contrast-enhanced computed tomography (CT) scan of the abdomen revealed dilated large bowel loops showing bird beak-like narrowing of the sigmoid colon and whirl sign, suggestive of sigmoid volvulus with bowel wall compromise associated with left adnexal torsion secondary to a large pelvic mass. The patient underwent an emergency laparotomy. Exploration showed a torsion of the left adnexa secondary to a large cyst of the left ovary, carrying the sigmoid colon with it, which produces a volvulus of the sigmoid colon with 720° anticlockwise rotation. A sigmoid colectomy and Hartmann’s procedure associated with a left adnexectomy were performed. Although rare, the occurrence of a volvulus of the sigmoid in the young woman must be suggestive of torsion of the adnexa. Surgical management must be prompt, allowing both the ovary and the sigmoid to be saved.

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