Parasitic myoma developing at the port site after laparoscopic myomectomy; a case report

Parasitic myomas occur especially after laparoscopic myomectomy and its incidence increases due to the use of morcellators. Parasitic myomas can rarely occur at the port entry site, being more commonly seen on the intestines, the omentum, the ureter, the bladder, and the diaphragm in different periods after surgery, the average duration being 24 months. In this article, we present the case of parasitic myoma developing secondary to the port site in a 45-year-old nulliparous woman after the use of laparoscopic myomectomy and morcellation 8 years ago. The patient presented with complaints of pelvic pain and a palpable mass in the left trocar incision line, and an appearance compatible with multiple myomas in the subcutaneous tissue of the left trocar incision line. Besides, myomas were also observed in the mesentery of the rectosigmoid colon and at the uterus in the present study. Numerous and large myomas were observed in the uterus, in the mesentery of the rectosigmoid colon, on the left pelvic peritoneum, and under the skin corresponding to the port entrance. The pathological examination of the myomas excised was reported as leiomyoma. In this article, the diagnosis, the treatment, the possible risk factors, and the complications of myomas were discussed in the light of the literature.

Fecal Impaction in the Rectum and Rectosigmoid Colon Secondary to Sunflower Seed Ingestion

A 35-month-old male who had eaten a bag of sunflower seeds initially presented to the emergency department (ED) with visible seeds in the anus and was discharged home with a stool softener after manual disimpaction. He then returned to the hospital 2 days later, and abdominal radiographs confirmed significant fecal material within the rectum and rectosigmoid colon. After failed oral and rectal laxative therapy attempts, subsequent disimpaction under anesthesia revealed an undigested sunflower seed bezoar in the rectum extending to the distal segment of his sigmoid colon. This case highlights the dangers and possible complications of seed ingestion even in small quantities in children along with the pathophysiology of impaction. This is one of the youngest cases reported in the United States involving the rectum and rectosigmoid colon with a sunflower bezoar.

EP.FRI.815 Hartmann’s at 100: Relevant or Redundant?

Introduction Henri Albert Hartmann first described resection of the rectosigmoid colon and exteriorization of the bowel with a colostomy in 1921. As we approach the centenary anniversary of Hartmann’s procedure we feel it is the appropriate time to discuss this significant surgical advancement and its relevance in modern day surgery. Methods We provide a contemporary overview of the literature, highlighting various aspects of the Hartmann’s procedure applicable to both today’s clinical practice and that of tomorrow. Results Hartmann’s procedure was initially performed for colorectal carcinoma in 1921. One hundred years on, the Hartmann’s procedure remains a safe and effective option in select patients with colorectal cancer and at high risk of anastomotic failure. In recent years, the majority of Hartmann’s procedures have been performed for benign disease and the majority of these cases are in the emergency setting. As hospital admissions with acute diverticulitis continue to rise steeply, the importance of the Hartmann’s procedure in the field of surgery continues. Hartmann’s procedure has adapted as surgery has advanced. Hartmann’s is now performed both laparoscopically and robotically with good postoperative outcomes. Conclusions In 1921, few would have predicted how modern day medicine and surgery is today. Hartmann’s procedure has survived the surgical test of time, and its key principles remain the same. As we look to the future, it is unlikely that it’s role will be lost to surgical advances, but to alternative management modalities in disease prevention.

Removal of unusual foreign body from rectosigmoid colon with colonoscope and forcep

Accidental foreign body ingestion is common among children and in many adults with or without systemic disease (altered mental status due to any cause), most of which is expelled spontaneously, some are removed endoscopically, laproscopically and surgically in complicated cases. Herein we are discussing a case of denture (of size about 5 x 5 cm) removal from sigmoid colon which was accidentaly swallowed with food in a normal conscious and alert person, with the help of colonoscope, proctoscope and forceps, without any complications except for mild bleeding which was managed conservatively