Successful Laparoscopic Treatment for Refractory Rectovaginal Fistula of Behçet's Disease: A Case Report and Review of the Literature

2016 ◽  
Author(s):  
Ryo Inada ◽  
Masaharu Oishi ◽  
Tomoko Matsumoto ◽  
Shigeyoshi Iwamoto ◽  
Taku Michiura ◽  
...  
Keyword(s):  
Rectovaginal Fistula ◽  
Clinical Course ◽  
Radical Surgery ◽  
Laparoscopic Treatment ◽  
Rectal Anastomosis ◽  
Double Stapling Technique ◽  
Case Presentation ◽  
Double Stapling ◽  
Fistula Recurrence ◽  
Anal Side

Abstract Abstract Introduction: Rectovaginal fistula caused by Behçet's disease is extremely rare, and the clinical course is very unfavorable. We describe rectovaginal fistula of Behçet's disease with successful laparoscopic treatment, and review the literature. Case presentation: A 30-year-old woman with Behçet's disease was diagnosed with rectovaginal fistula, and treated medically after fecal diversion colostomy. However, the fistula remained, and she underwent radical surgery. Laparoscopically, after mobilization of the rectum, the fistula was removed. The rectum was transected on the anal side of the fistula, and removed after extraction through the vaginal incision. The vaginal incision was repaired by suturing, and rectal anastomosis was performed using a double-stapling technique. The omentum was fixed between the rectum and vagina, and the operation was completed. Six months after the laparoscopic surgery, no evidence of fistula recurrence has been seen on colonoscopy. Conclusion: We have reported a rare case of rectovaginal fistula of Behçet's disease treated with an altogether new surgical approach that might prove effective for refractory rectovaginal fistula.

scholarly journals Rectovaginal Fistula after Low Anterior Resection for Rectal Cancer Using a Double Stapling Technique

2010 ◽  
Vol 4 (2) ◽  
pp. 224-228 ◽  
Author(s):  
Satoshi Yodonawa ◽  
Isao Ogawa ◽  
Susumu Yoshida ◽  
Hiromichi Ito ◽  
Keisuke Kobayashi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Rectovaginal Fistula ◽  
Low Anterior Resection ◽  
Double Stapling Technique ◽  
Stapling Technique ◽  
Double Stapling

Fever in the returning traveller: Dual infection with SARS-CoV-2 and Plasmodium falciparum malaria

2020 ◽  
pp. 105-108
Author(s):  
MA Parker ◽  
E Nell ◽  
A Mowlana ◽  
MS Moolla ◽  
S Karamchand ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Falciparum Malaria ◽  
Clinical Course ◽  
Febrile Illness ◽  
Plasmodium Falciparum Malaria ◽  
Dual Infection ◽  
Pneumocystis Pneumonia ◽  
Case Presentation ◽  
Presenting Symptoms ◽  
Uncomplicated Plasmodium Falciparum Malaria

Background: More than 90% of the global 400 000 annual malaria deaths occur in Africa. The current SARS-CoV-2 pandemic has resulted in more than 830 000 deaths in its first 10 months. Case presentation: This case describes a patient who had travelled from Mozambique to Cape Town, presented with a mild febrile illness, and was diagnosed with both COVID-19 and uncomplicated Plasmodium falciparum malaria infection. She responded well to malaria treatment and had an uneventful COVID-19 admission. Her blood smear showed a low malaria parasitaemia and a relatively high gametocyte load. Conclusion: We postulate that her clinical course and abnormal smear could well be due to reciprocal disease-modifying effects of the infections. The presenting symptoms of COVID-19 may mimic endemic infectious diseases including malaria, tuberculosis, pneumocystis pneumonia and influenza thus there is a need for clinical vigilance to identify and treat such co-infections.

scholarly journals Laparoscopic treatment for celiac artery stenosis caused by median arcuate ligament compression with Adachi V type vascular anomaly: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hiroshi Saito ◽  
Koichiro Sawada ◽  
Jyunichi Ogawa ◽  
Masashi Hashimoto ◽  
Masahiro Oshima ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Vascular Anomaly ◽  
Celiac Artery ◽  
Artery Stenosis ◽  
Laparoscopic Treatment ◽  
Median Arcuate Ligament ◽  
Case Presentation ◽  
Arcuate Ligament ◽  
Major Vascular Injury

Abstract Background Median arcuate ligament syndrome (MALS), which results from compression of the median arcuate ligament (MAL), is a rare cause of abdominal pain and weight loss. Treatment is dissection of the MAL; however, the laparoscopic procedure is not yet established and it involves the risk of major vascular injury, especially in cases with an anomaly. Case presentation A 47-year-old man was evaluated at the hospital for epigastric pain. Contrast computed tomography scan revealed stenosis of the celiac artery origin due to the MAL. An Adachi V type vascular anomaly was also observed. Laparoscopic treatment was performed to release pressure on the celiac artery. Laparoscopic ultrasonography was used to less invasively confirm the release of the MAL. Despite a concomitant Adachi V type vascular anomaly, surgery was safely performed using the laparoscopic magnification view and intraoperative ultrasonography. Follow-up ultrasonography confirmed the celiac artery stenosis has not recurred. Conclusions A rare case of MALS with an Adachi V type vascular anomaly is presented and the laparoscopic treatment is detailed.

scholarly journals Early radical cystectomy with negative margins in a 57-year-old female with myxoid/round cell liposarcoma of the bladder suggests prolonged overall survival

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Johannes Eduard Delport ◽  
Khanyisa Makamba
Keyword(s):  
Overall Survival ◽  
Surgical Intervention ◽  
Radical Surgery ◽  
Bladder Tumour ◽  
Eastern Cape ◽  
Round Cell ◽  
Female Population ◽  
Case Presentation ◽  
Rural Town ◽  
Common Cancer

Abstract Background Bladder cancer is the 17th most common cancer in the female population. Most bladder cancers are of urothelial origin. Sarcomas of the bladder are very uncommon. Case presentation This case concerns a 57-year-old female from a rural town in the Eastern Cape who was diagnosed with myxoid/round cell liposarcoma of the bladder. After the initial transurethral resection of the bladder tumour, she underwent an anterior exenteration with Bricker’s diversion (ileal conduit) and negative margins were achieved. Conclusions Sarcomas of the bladder are known to have a poor prognosis. Our patient is alive with good stoma function more than 24 months since her radical surgery. We are of the opinion that her favourable overall survival is attributable to early radical surgical intervention with negative margins.

scholarly journals Leptospirosis presenting as severe cardiogenic shock: A case report

2018 ◽  
Vol 19 (4) ◽  
pp. 351-353
Author(s):  
E Forbat ◽  
MJ Rouhani ◽  
C Pavitt ◽  
S Patel ◽  
R Handslip ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiogenic Shock ◽  
Social History ◽  
Rare Case ◽  
Clinical Course ◽  
Unknown Origin ◽  
Case Presentation ◽  
Pyrexia Of Unknown Origin ◽  
Severe Cardiogenic Shock ◽  
Infectious Illness

Background Leptospirosis is a rare infectious illness caused by the Spirochaete Leptospira. It has a wide-varying spectrum of presentation. We present a rare case of severe cardiogenic shock secondary to leptospirosis, in the absence of its common clinical features. Case presentation A 36-year-old woman presented to our unit with severe cardiogenic shock and subsequent multi-organ failure. Her clinical course was characterised by ongoing pyrexia of unknown origin with concurrent cardiac failure. She was initially managed with broad-spectrum antibiotics and inotropes. Percutaneous cardiac biopsy excluded major causes of myocarditis. On day 21 after presentation, she was found to be IgM-positive for leptospirosis. Conclusions This is a rare case of severe cardiogenic shock secondary to leptospirosis infection. The case also highlights the importance of obtaining a thorough social history when assessing a patient with an unusual presentation, as clues can often be missed.

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