Recurrent Intussusception in Adolescence: A Rare Entity

Background: A lipoma is one of the commonest benign tumors in surgical practice. Lipomas are usually found on the trunk and limbs but less commonly within the abdomen, where they occur frequently in the mesentery as well as the subserosa and submucous layer of the gastrointestinal tract. Pre-peritoneal lipomas are rare. Case Presentation: A 44-year-old woman presented with a painless and progressive right-sided abdominal swelling of 5 months duration. Examination revealed a 16cm x 14cm slightly mobile and non-tender firm-to-hard hour-glass-shaped mass extending from the right hypochondrial to right iliac and the suprapubic regions. Abdominal ultrasonography showed a 5cm x 6cm bowel thickening in the right iliac fossa suggestive of an ileocecal mass while a computerized tomography showed a 20.8cm x 6.3cm x 20.1cm hypodense mass within the peritoneal cavity, extending from the epigastric region to the pelvis, anterior to the bowel loops and more to the right. At laparotomy, a huge, well encapsulated yellowish mass in the pre-peritoneal space, weighing 1,520g was excised. Histology confirmed a lipoma. Conclusion: A preperitoneal lipoma is an uncommon soft tissue tumor and the giant ones are extremely rare. Although a rare cause of a painless abdominal swelling, pre-peritoneal lipoma should be considered as a differential diagnosis in patients presenting with an unremarkable feature suggestive of an intra-abdominal pathology.

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INTESTINAL MALROTATION IN 35 YEAR OLD WOMEN FROM PESHAWAR, PAKISTAN

Gomal Journal of Medical Sciences ◽

10.46903/gjms/17.04.2097 ◽

2019 ◽

Vol 17 (4) ◽

pp. 145-149

Author(s):

Zubair Ahmad Khan ◽

Omer Nasim ◽

Zeinab Hussain ◽

Jamil Ahmad

Keyword(s):

Emergency Department ◽

Iliac Fossa ◽

Exploratory Laparotomy ◽

Acute Onset ◽

Midgut Volvulus ◽

Left Iliac Fossa ◽

Operative Care ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

The Right

Thirty five years old women presented to the Accident and Emergency Department with acute onset right upper quadrant abdominal pain with normal vitals. CT images revealed a malrotation causing midgut volvulus and intestinal obstruction. On emergency exploratory laparotomy, the gut loops showed partial ischemia due to a double twist at the root of mesentery and malrotation of the gut along with the caecum which was mobile coming from left iliac fossa and lying in the right iliac fossa. Duodeno-jejunal junction was identified. The coils of the intestine were untwisted and rotation was corrected. The gut color changed back to normal. She was discharged painless after routine post-operative care.

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A Giant Right Coronary Artery of Diffuse Ectasia Induced by a Right Ventricular Fistula

The Heart Surgery Forum ◽

10.1532/hsf.1349 ◽

2015 ◽

Vol 18 (6) ◽

pp. 253

Author(s):

Renyuan Li ◽

Yiming Ni ◽

Peng Teng ◽

Weidong Li

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Artery Bypass ◽

Coronary Artery Fistula ◽

Rare Entity ◽

Fistula Closure ◽

Unique Case ◽

Coronary Ectasia ◽

The Right ◽

Giant Size

<p>Coronary artery fistula (CAF) is a rare entity. Sometimes it may associate with mild diffuse or segmental coronary ectasia. CAF with giant coronary artery is exceptionally rare. We present a unique case of a 49-year-old female patient with a giant right coronary artery of diffuse ectasia coexisting with a fistula draining into the right ventricle. To our best knowledge, CAF with diffuse coronary ectasia of such giant size has never been reported. The patient was treated successfully by resection of the dilated right coronary artery, fistula closure, and coronary artery bypass grafting.</p>

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

BMC Women s Health ◽

10.1186/s12905-021-01408-z ◽

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.

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Cystic papillary adenoma of the seminal vesicle

BMC Urology ◽

10.1186/s12894-021-00830-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

B. Heijkoop ◽

D. Bolton ◽

D. Katz ◽

Andrew Ryan ◽

J. Epstein ◽

...

Keyword(s):

Seminal Vesicle ◽

Rare Case ◽

Groin Pain ◽

Iliac Fossa ◽

Papillary Adenoma ◽

Rare Entity ◽

Macroscopic Haematuria ◽

Case Presentation ◽

Adjacent Organ ◽

Epithelial Tumours

Abstract Background Primary Seminal Vesicle (SV) tumours are a rare entity, with most SV masses representing invasion of the SV by malignancy originating in an adjacent organ, most often the prostate. Previously reported primary SV epithelial tumours have included adenocarcinoma and cystadenoma, with limited prior reports of inracystic papillary structures. Case presentation A 35-year-old male presented with azoospermia, intermittent macroscopic haematuria, and mild right iliac fossa and groin pain. A papillary appearing seminal vesicle mass was found on imaging and seminal vesicoscopy. The mass was robotically excised with diagnosis of benign cystic papillary adenoma made. Conclusion In this manuscript we describe a rare case of a benign cystic papillary adenoma of the seminal vesicle, a unique histological entity differentiated from cystadenoma of the Seminal Vesicle by its papillary component.

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Neonatal transcatheter closure of a right pulmonary artery to left atrium fistula

Cardiology in the Young ◽

10.1017/s1047951121000068 ◽

2021 ◽

pp. 1-3

Author(s):

Claire Bertail-Galoin

Keyword(s):

Prenatal Diagnosis ◽

Pulmonary Artery ◽

Left Atrium ◽

Neonatal Period ◽

Transcatheter Closure ◽

Rare Entity ◽

Amplatzer Duct Occluder ◽

Right Pulmonary Artery ◽

The Right ◽

Surgical Treatments

Abstract A fistula between the pulmonary artery and the left atrium is a rare entity and its diagnosis is uncommon in the neonatal period. There are more reported surgical treatments in the literature than with a transcatheter closure. We report the case of a prenatal diagnosis of a large fistula between the right pulmonary artery and the left atrium with successful transcatheter closure with an Amplatzer duct occluder II 6/4 mm.

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A rare encounter of obstructed direct inguinal hernia

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v22i2.28745 ◽

2019 ◽

Vol 22 (2) ◽

pp. 41-43

Author(s):

Amit Kumar Singh ◽

Nripesh Rajbhandari ◽

Balaram Malla ◽

Gakul Bhatta

Keyword(s):

Emergency Department ◽

Inguinal Hernia ◽

Intestinal Obstruction ◽

Intestinal Resection ◽

Posterior Wall ◽

Acute Intestinal Obstruction ◽

University Hospital ◽

Direct Inguinal Hernia ◽

Direct Hernia ◽

The Right

The direct inguinal hernia has a wider neck and thus usually doesn’t present as strangulation or incarceration in comparison to the indirect component. When direct inguinal hernias are untreated for a longer duration, they may get strangulated and incarcerated. Hence such long-standing direct hernias with features of intestinal obstruction and /or peritonism should be promptly seen and diagnosed to prevent massive and unwanted intestinal resection. We are reporting a case of 83-year-old male presented to Surgical Emergency Department of Dhulikhel Hospital, Kathmandu University hospital with complaints of swelling in the right inguinoscrotal region for 12 years and progressed to become irreducible and painful for 12 hours. Clinically he had an acute intestinal obstruction. Intra-operatively we found a direct hernia containing congested small bowel loops and toxic fluids. The toxic fluid was suctioned and after confirming viability, modified Bassini’s repair was done with reinforcement of the posterior wall. Even direct inguinal hernia of longer duration can cause acute or sub-acute intestinal obstruction with or without features of peritonism. This complication is more common in elderly patients.

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Squamous Cell Carcinoma of Kidney and Its Prognosis: A Case Report and Review of the Literature

Case Reports in Urology ◽

10.1155/2015/469327 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Tapan Kumar Sahoo ◽

Saroj Kumar Das ◽

Chandraprava Mishra ◽

Ipsita Dhal ◽

Rohani Nayak ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Radical Nephrectomy ◽

Advanced Stage ◽

Rare Entity ◽

Primary Squamous Cell Carcinoma ◽

Review Of The Literature ◽

Radiological Features ◽

The Right

Primary squamous cell carcinoma of the renal parenchyma is an extremely rare entity. The diagnosis of squamous cell carcinoma of the renal pelvis is usually unsuspected due to the rarity and inconclusive clinical and radiological features. Most of the patients are diagnosed at an advanced stage and are with poor outcome. Radical nephrectomy is the mainstay of the treatment. We reported a case of squamous cell carcinoma of the kidney in a 50-year-old female who presented with the right sided abdomen pain. The patient was treated with radical nephrectomy.

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Type 4 appendiceal diverticulum within a de Garengeot hernia

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0185 ◽

2016 ◽

Vol 98 (7) ◽

pp. e141-e142 ◽

Cited By ~ 1

Author(s):

SH Rossi ◽

E Coveney

Keyword(s):

Femoral Hernia ◽

Cystic Lesion ◽

Vermiform Appendix ◽

Clinical Suspicion ◽

Intraluminal Pressure ◽

Rare Entity ◽

History Of ◽

The Right ◽

De Garengeot Hernia ◽

Learning Points

A de Garengeot hernia is defined as an incarcerated femoral hernia containing the vermiform appendix. We describe the case of a patient with a type 4 appendiceal diverticulum within a de Garengeot hernia and delineate valuable learning points.A 76-year-old woman presented with a 2-week history of a non-reducible painless femoral mass. Outpatient ultrasonography demonstrated a 36mm × 20mm smooth walled, multiloculated, partially cystic lesion anterior to the right inguinal ligament in keeping with an incarcerated femoral hernia. Intraoperatively, the appendix was found to be incarcerated in the sac of the femoral hernia and appendicectomy was performed. Histopathology demonstrated no evidence of inflammation in the appendix. However, an incidental appendiceal diverticulum was identified.It is widely recognised that a de Garengeot hernia may present with concomitant appendicitis, secondary to raised intraluminal pressure in the incarcerated appendix. Appendiceal diverticulosis is also believed to develop in response to raised pressure in the appendix and may therefore develop secondary to incarceration in a de Garengeot hernia. To our knowledge, only one such case has been described in the literature. A de Garengeot hernia is a rare entity, which poses significant diagnostic challenges. A high index of clinical suspicion is necessary as these hernias are at particularly high risk of perforation and so prompt surgical management is paramount.

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