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 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 Ileo-colic intussusception by ileo-cecal valve lipoma – an infrequent ultrasonographic occurrence. A case report.

2016 ◽  
Vol 18 (3) ◽  
pp. 394
Author(s):  
Bogdan Stancu ◽  
Alexandra Chira ◽  
Romeo Ioan Chira ◽  
Ioana Grigorescu ◽  
Claudia Diana Gherman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Pathological Examination ◽  
Contrast Enhanced ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Polypoid Tumor

We present a rare cause of intestinal obstruction in an adult, due to ileo-colic intussusception by a lipoma of the ileo-cecal valve and its ultrasonographic presentation. The case presented in emergency for spontaneously appearing and disappearing palpable elastic mass in the right iliac fossa. The ultrasonographic examination raised the suspicion of an ileo-colic intussusception due to a polypoid tumor. The contrast-enhanced computed tomography confirmed the finding and suggested that the polypoid tumor was more likely a lipoma. Right hemicolectomy and cholecystectomy were performed and the pathological examination confirmed the lipoma. The evolution of the patient was favourable and uneventful.

scholarly journals Role of MSCT in the diagnosis of perforated gall bladder (a retrospective study)

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed M. Harraz ◽  
Ahmed H. Abouissa
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Acute Diverticulitis ◽  
Wall Thickening ◽  
Free Fluid ◽  
Iodinated Contrast ◽  
Contrast Enhanced

Abstract Background Although gall bladder perforation (GBP) is not common, it is considered a life-threating condition, and the possibility of occurrence in cases of acute cholecystitis must be considered. The aim of this study was to assess the role of multi-slice computed tomography (MSCT) in the assessment of GBP. Results It is a retrospective study including 19 patients that had GBP out of 147, there were 11 females (57.8%) and 8 males (42.1%), aged 42 to 79 year (mean age 60) presented with acute abdomen or acute cholecystitis. All patients were examined with abdominal ultrasonography and contrast-enhanced abdominal MSCT after written informed consent was obtained from the patients. This study was between January and December 2018. Patients with contraindications to contrast-enhanced computed tomography (CT) (pregnancy, acute kidney failure, or allergy to iodinated contrast agents) who underwent US only were excluded. Patients with other diagnoses, such as acute diverticulitis of the right-sided colon or acute appendicitis, were excluded. The radiological findings were evaluated such as GB distention; stones; wall thickening, enhancement, and defect; pericholecystic free fluid or collection; enhancement of liver parenchyma; and air in the wall or lumen. All CT findings are compared with the surgical results. Our results revealed that the most important and diagnostic MSCT finding in GBP is a mural defect. Nineteen patients were proved surgically to have GBP. Conclusion GBP is a rare but very serious condition and should be diagnosed and treated as soon as possible to decrease morbidity and mortality. The most accurate diagnostic tool is the CT, MSCT findings most specific and sensitive for the detection of GBP and its complications.

scholarly journals Airway Foreign Body Mimicking an Endobronchial Tumor Presenting with Pneumothorax in an Adult: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 50
Author(s):  
Jun-Ho Ha ◽  
Byeong-Ho Jeong
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Chest Tube ◽  
Biopsy Forceps ◽  
Chest Computed Tomography ◽  
Contrast Enhanced ◽  
Lobar Bronchus ◽  
Green Pea ◽  
Airway Foreign Body ◽  
The Right

Foreign body (FB) aspiration occurs less frequently in adults than in children. Among the complications related to FB aspiration, pneumothorax is rarely reported in adults. Although the majority of FB aspiration cases can be diagnosed easily and accurately by using radiographs and bronchoscopy, some patients are misdiagnosed with endobronchial tumors. We describe a case of airway FB that mimicked an endobronchial tumor presenting with pneumothorax in an adult. A 77-year-old man was referred to our hospital due to pneumothorax and atelectasis of the right upper lobe caused by an endobronchial nodule. A chest tube was immediately inserted to decompress the pneumothorax. Chest computed tomography with contrast revealed an endobronchial nodule that was seen as contrast-enhanced. Flexible bronchoscopy was performed to biopsy the nodule. The bronchoscopy showed a yellow spherical nodule in the right upper lobar bronchus. Rat tooth forceps were used, because the lesion was too slippery to grasp with ellipsoid cup biopsy forceps. The whole nodule was extracted and was confirmed to be a FB, which was determined to be a green pea vegetable. After the procedure, the chest tube was removed, and the patient was discharged without any complications. This case highlights the importance of suspecting a FB as a cause of pneumothorax and presents the possibility of misdiagnosing an aspirated FB as an endobronchial tumor and selecting the appropriate instrument for removing an endobronchial FB.

scholarly journals How Can We Manage Gallbladder Lesions by Transabdominal Ultrasound?

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 784
Author(s):  
Shinji Okaniwa
Keyword(s):  
High Frequency ◽  
Layer Structure ◽  
Wall Layer ◽  
Pancreaticobiliary Maljunction ◽  
Doppler Imaging ◽  
Wall Thickening ◽  
Contrast Enhanced ◽  
Postural Changes ◽  
Venous Phase

The most important role of ultrasound (US) in the management of gallbladder (GB) lesions is to detect lesions earlier and differentiate them from GB carcinoma (GBC). To avoid overlooking lesions, postural changes and high-frequency transducers with magnified images should be employed. GB lesions are divided into polypoid lesions (GPLs) and wall thickening (GWT). For GPLs, classification into pedunculated and sessile types should be done first. This classification is useful not only for the differential diagnosis but also for the depth diagnosis, as pedunculated carcinomas are confined to the mucosa. Both rapid GB wall blood flow (GWBF) and the irregularity of color signal patterns on Doppler imaging, and heterogeneous enhancement in the venous phase on contrast-enhanced ultrasound (CEUS) suggest GBC. Since GWT occurs in various conditions, subdividing into diffuse and focal forms is important. Unlike diffuse GWT, focal GWT is specific for GB and has a higher incidence of GBC. The discontinuity and irregularity of the innermost hyperechoic layer and irregular or disrupted GB wall layer structure suggest GBC. Rapid GWBF is also useful for the diagnosis of wall-thickened type GBC and pancreaticobiliary maljunction. Detailed B-mode evaluation using high-frequency transducers, combined with Doppler imaging and CEUS, enables a more accurate diagnosis.

scholarly journals Laparoscopic approach in the treatment of echinococcal liver disease - case report and literature review

2020 ◽  
Vol 148 (7-8) ◽  
pp. 480-483
Author(s):  
Nikola Grubor ◽  
Boris Tadic ◽  
Vladimir Milosavljevic ◽  
Djordje Knezevic ◽  
Slavko Matic
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Open Surgery ◽  
Laparoscopic Approach ◽  
Parasitic Disease ◽  
Hydatid Cysts ◽  
Disease Case ◽  
Right Lobe ◽  
The Right ◽  
Hepatic Hydatid

Introduction. Cystic echinococcosis or hydatid disease is a parasitic disease, zoonosis, and is most commonly caused by Echinococcus granulosus larvae. It mainly occurs in endemic areas. The most common localization is the liver. Case outline. In this paper, we will present our experience with a 67-year-old female patient diagnosed with an echinococcal cyst in the right lobe of the liver, as confirmed by computed tomography examination of the abdomen. The patient underwent laparoscopic partial pericystectomy with omentoplasty. The operation went without complications, as well as the postoperative period. Conclusion. Laparoscopic partial pericystectomy is a safe and effective treatment of available hepatic hydatid cysts. Considering all the benefits of minimally invasive surgery, laparoscopic partial pericystectomy of hepatic hydatid cysts may be the treatment of choice, over the classical open surgery approach.

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 Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion

2021 ◽  
Vol 5 (4) ◽  
pp. 468-469
Author(s):  
Joshua Livingston ◽  
Savannah Gonzales ◽  
Mark Langdorf
Keyword(s):  
Computed Tomography ◽  
Lower Abdominal Pain ◽  
Cystic Mass ◽  
Ovarian Torsion ◽  
Venous Flow ◽  
Contrast Enhanced ◽  
Whirlpool Sign ◽  
Ovarian Pathology ◽  
The Right ◽  
Enhanced Computed Tomography

Case Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transvaginal pelvic ultrasound (US) revealed a hemorrhagic cyst in the right adnexa, with duplex Doppler identifying arterial and venous flow in both ovaries. Laparoscopic surgery confirmed right ovarian torsion with an attached cystic mass, and a right salpingo-oophorectomy was performed given the mass was suspicious for malignancy. Discussion: Ultrasound is the test of choice for diagnosis of torsion due to its ability to evaluate anatomy and perfusion. When ovarian pathology is on the patient’s right, appendicitis is high in the differential diagnosis, and CT may be obtained first. Here we describe a case where CT first accurately diagnosed ovarian torsion by demonstrating the whirlpool sign, despite an US that showed arterial flow to the ovary. Future studies should determine whether CT alone is sufficient to diagnose or exclude ovarian torsion.

scholarly journals Misdiagnosis of Rectus Abdominis Abscess Owing to Delayed Contrast-Enhanced Computed Tomography

2021 ◽  
Author(s):  
Yuichiro Nagase ◽  
Yukinori Harada
Keyword(s):  
Computed Tomography ◽  
Laboratory Tests ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A 77-year-old man, who was on anticoagulation, presented with a painful lump on the right abdominal wall. Laboratory tests showed slight anaemia and elevated inflammatory markers. Abdominal plain computed tomography (CT) revealed a mass in the right rectus abdominis muscle. He was admitted with a diagnosis of primary rectus abdominis haematoma. However, on the next day, the diagnosis was corrected to primary rectus abdominis abscess, following contrast-enhanced CT of the abdomen. This case illustrates the importance of considering primary rectus abdominis abscess in patients with suspected primary rectus abdominis haematoma, and contrast should be used when performing CT.

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.

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