scholarly journals HugeNon-Organ Retroperitoneal Tumor inCombination with aCystoma of Uterine Appendages

2019 ◽  
Vol 4 (2) ◽  
pp. 140-143
Author(s):  
N. I. Bogomolov ◽  
A. G. Goncharov ◽  
N. N. Tomskikh ◽  
Y. Y. Goncharova
Keyword(s):  
Intestinal Anastomosis ◽  
Abdominal Cavity ◽  
Lymph Node Biopsy ◽  
Tumor Formation ◽  
Retroperitoneal Space ◽  
Abdominal Tumor ◽  
Mesenteric Vessels ◽  
Median Laparotomy ◽  
Horizontal Portion ◽  
The Right

The article describes the experience of successful diagnostics and treatment of giant non-organ extraperitoneal tumor combined with a cystoma of uterine appendages.Patient P., 43 years old, was hospitalized in the oncology department, diagnosed with “Abdominal tumor, right ovary?” The state was satisfactory, after palpation of the abdomen, a lumpy formation of a densely elastic consistency, from the womb to the epigastric region, was found. An ultrasound revealed a homogeneous tumor formation 30×28 cm from the border of the uterus to the liver. When performing median laparotomy, a dumbbell-shaped tumor (36×26×20 cm) was found in the retroperitoneal space with involvement of the mesentery of the small intestine, lower horizontal portion of the duodenum, mesentery of the transverse colon, superior mesenteric vessels, aorta and jejunum. In the right appendages, a cystoma 12–15 cm in diameter was found, with inversion and necrosis. Adnexectomy was performed. An express lymph node biopsy revealed cells suspicious for malignancy. The tumor was mobilized and removed as a single unit with retroperitoneal tissue, lymph nodes in combination with resection of 70 cm of the jejunum and fenestrated resection of the duodenum. The resulting gut defect 9×7 cm was sutured with a precision single-row suture. Inter-intestinal anastomosis “endto-end” was formed. Nasointestinal intubation was performed. The abdominal cavity was sutured, and two tubular drainages were installed. The postoperative period was uneventful. The histological conclusion: fibrous histiocytoma of the mesentery of the intestine with malignancy in the center of the node, in the ovary – total hemorrhagic infiltration of all layers, edema. The tumor conference consultation was recommended. After 1.5 years, the patient was admitted with the same clinical picture. During laparotomy, a tumor recurrence was discovered, the nodes of which were located in the retroperitoneal space, in the abdominal cavity with invasion to organs and large vessels. The case was recognized as inoperable, the laparotomic wound was closed completely. Sixteen days after surgery the patient was discharged.

scholarly journals CLINICAL CASE OF APPENDIX MUCOCELL, COMPLICATED BY PERFORATION AND THE FORMATION OF RETROPERITONEAL SPACE PHLEGMON

2020 ◽  
pp. 110-114
Author(s):  
О. А. Povch ◽  
Е. N. Shepetko ◽  
О. V. Коvalchuk ◽  
R. О. Leleta ◽  
S. О. Rebenkov
Keyword(s):  
Preoperative Diagnosis ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Retroperitoneal Space ◽  
Medical Attention ◽  
Timely Manner ◽  
Gradual Improvement ◽  
Mucocele Of The Appendix ◽  
The Right

Summary. The aim. To analyze the anamnestic data, clinical symptoms, preoperative diagnosis, features of surgical intervention and the results of histological examination in a patient with mucocele of the appendix (MA), complicated by necrosis and perforation of the wall and formation of retroperitoneal space phlegmon (FRS). Material and methods. An analysis of the case of MA, which was complicated by the atypical course and the development of retroperitoneal space phlegmon, which was diagnosed after multispiral computered tomography of the abdominal cavity (MSCT AC). Results. The patient, despite periodic atypical complaints of discomfort in the right iliac region, did not seek medical attention and was not examined. Operated urgently after performing MSCT AC. Intraoperatively, a rupture of the MA was diagnosed with formation of FRS, which significantly complicated the course of the operation and the course of the postoperative period. Appendectomy, drainage of the abdominal cavity and retroperitoneal space were performed. Gradual improvement and recovery. Conclusions: The acute situation resulting from the rupture of the MA, led to a complex operation. Performing MSCT AC at the prehospital stage makes it possible to diagnose the problem and perform the operation in a timely manner, without waiting for serious complications.

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

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.

scholarly journals Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoki Enomoto ◽  
Kazuhiko Yamada ◽  
Daiki Kato ◽  
Shusuke Yagi ◽  
Hitomi Wake ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Abdominal Cavity ◽  
Three Dimensional ◽  
Simulation Software ◽  
3D Simulation ◽  
Diaphragmatic Defect ◽  
Intestinal Malrotation ◽  
Intestinal Loop ◽  
Bochdalek Hernia ◽  
The Right

Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.

scholarly journals Minilaparotomy a Good Option in Specific Cases: A Case Report of Bilateral Ovarian Germ Cell Tumor

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
D. Bolla ◽  
N. Deseö ◽  
A. Sturm ◽  
A. Schöning ◽  
C. Leimgruber
Keyword(s):  
Acute Abdominal Pain ◽  
Adnexal Mass ◽  
Past History ◽  
Ovarian Tissue ◽  
Abdominal Cavity ◽  
Operating Time ◽  
Expectant Management ◽  
Small Incision ◽  
Risk Of Rupture ◽  
The Right

Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6 cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue.

HETEROTOPIC PREGNANCY WITH INEVITABLE ABORTION (RIGHT ADNEXAL LIVE ECTOPIC AND COEXISTING INTRAUTERINE TRIPLETS WITH ABSENT FETAL CARDIAC ACTIVITY)

2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Short Period ◽  
The Right

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.

scholarly journals Comparative study of inflammatory response and adhesions formation after fixation of different meshes for inguinal hernia repair in rabbits

2005 ◽  
Vol 20 (5) ◽  
pp. 347-352 ◽  
Author(s):  
Alberto Goldenberg ◽  
Jacques Matone ◽  
Wagner Marcondes ◽  
Fernando Augusto Mardiros Herbella ◽  
José Francisco de Mattos Farah
Keyword(s):  
Inflammatory Response ◽  
Abdominal Wall ◽  
Peritoneal Cavity ◽  
Abdominal Cavity ◽  
Mesh Fixation ◽  
Rabbit Model ◽  
Laparoscopic Approach ◽  
Preperitoneal Space ◽  
Similar Amount ◽  
The Right

PURPOSE: Compare, in a rabbit model, the inflammatory response and adhesions formation following surgical fixation of polypropilene and Vypro mesh in the inguinal preperitoneal space. METHODS: Fourteen male New Zealand rabbits, weighing between 2.000 to 2.500 g were used. A midline incision was made and the peritoneal cavity was exposed. The 2,0X1,0 cm polypropylene mesh was fixed in the left flank and secured to the margins with 3-0 prolene in a separate pattern. In the right flank, a 2,0X1,0 cm Vypro II mesh was sewn in the same way. After the post surgical period, the animals were again anesthetized and underwent laparoscopic approach, in order to identify and evaluate adhesions degree. Both fixed prosthesis were excised bilaterally with the abdominal wall segment, including peritoneum, aponeurosis and muscle and sent to a pathologist RESULTS: Operative time ranged from 15 to 25 minutes and no difficulties in applying the mesh were found. From the 14 polypropylene meshes fixed to the intact peritoneum, 11 had adhesions to the abdominal cavity (78,6%). Concerning Vypro mesh, 12 animals developed adhesions from the 14 with mesh fixation (85,7%). Histological examination of tissues harvested revealed fibroblasts, collagen, macrophages and lymphocytes between the threads of the mesh. CONCLUSION: Polypropylene and Vypro mesh, when implanted in the peritoneal cavity of rabbits provoke similar amount of adhesions. Vypro mesh tissues had higher fibrosis resulting in better mesh incorporation to the abdominal wall.

scholarly journals Occurrence of parasitism by Dioctophyma renale in ring-tailed coatis (Nasua nasua) of the Tiete Ecological Park, São Paulo, Brazil

2009 ◽  
Vol 29 (12) ◽  
pp. 959-962 ◽  
Author(s):  
Liliane Milanelo ◽  
Márcia Bento Moreira ◽  
Lílian S. Fitorra ◽  
Bruno S.S. Petri ◽  
Melissa Alves ◽  
...  
Keyword(s):  
Population Control ◽  
Abdominal Cavity ◽  
Exploratory Laparotomy ◽  
Renal Tissue ◽  
Intermediate Hosts ◽  
Wild Mammals ◽  
Rigid Structure ◽  
Nasua Nasua ◽  
Males And Females ◽  
The Right

Dioctophymosis is a worldwide renal parasitosis caused by the Dioctophyma renale nematode, which results in progressive destruction of renal tissue. Aquatics annelids are considered the main intermediate hosts and the literature refers as permanent hosts of dogs, wild mammals and even humans. During procedures for population control of coatis (Nasua nasua) in the Ecological Park of Tietê (PET), was noticed the presence of parasitosis by D. renale. From 68 animals, males and females, young and adults, submitted to exploratory laparotomy, 51 were positive for the presence of worms, 9 were found only in the right kidney. In 10 cases, in addition to right kidney parasitism, worms were also observed in the abdominal cavity. In 24 cases D. renale was found only in the abdominal cavity and in 8 animals the right kidney was reduced to a small rigid structure. The study showed that the preferred site for parasitism of the worm, considered erratic, was the abdominal cavity in 66.66% of the cases.

scholarly journals Exclusive Phlebosclerosis of Submucosal Veins Leading to Ischemic Necrosis and Perforation of the Large Bowel: First European Case

2018 ◽  
Vol 12 (1) ◽  
pp. 137-142 ◽  
Author(s):  
Sebastian Klein ◽  
Denise Buchner ◽  
De-hua Chang ◽  
Reinhard Büttner ◽  
Uta Drebber ◽  
...  
Keyword(s):  
Wall Thickening ◽  
Caucasian Woman ◽  
Ischemic Necrosis ◽  
Colonic Wall ◽  
Asian Patients ◽  
Life Threatening ◽  
History Of ◽  
Mesenteric Vessels ◽  
The Right ◽  
European Woman

Phlebosclerotic colitis (PC) is a rare, potentially life-threatening disease of unclear pathogenesis almost exclusively reported in Asian patients of both genders. A fibrous degeneration of venous walls leads to threadlike calcifications along mesenteric vessels and colonic wall thickening, detectable by CT. This causes disturbed blood drainage and hemorrhagic infarction of the right-sided colonic wall. This is a report of PC in a Caucasian woman in Europe without Asian background and no history of herbal medications, a suspected cause in Asian patients. CT revealed no calcification of the mesenteric vein or its tributaries. Instead, submucosal veins of the left-sided colonic wall were calcified, leading to subsequent transmural necrosis. Clinically, the patient developed a paralytic ileus and sigmoidal perforation during a 2-week hospitalization due to a bleeding cerebral vascular aneurysm. This case of a European woman with PC is unique in its course as well as its radiologic, clinical, and pathologic presentation.

scholarly journals Diagnostic difficulties and features of endovideosurgical treatment of a patient with mucocele of the appendix

2020 ◽  
Vol 12 (2) ◽  
pp. 85-90
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Elguja L. Lataria ◽  
Alexey A. Kurkov ◽  
Vyacheslav A. Melnikov ◽  
...  
Keyword(s):  
Benign Tumor ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Vermiform Appendix ◽  
Diagnostic Methods ◽  
Number Of Patients ◽  
Mucocele Of The Appendix ◽  
Diagnostic Difficulties ◽  
Life Threatening ◽  
The Right

The mucocele of the appendix is the expansion of the appendix with the accumulation of a large amount of mucus. The mechanism and causes of mucocele are not fully understood. According to some authors, such changes in the appendix can occur due to cicatricial narrowing of the lumen of the appendix, compression or blockage of its base. Other authors believe that the mucocele of the appendix is a benign tumor that develops from the remnants of primitive mesenchyme and is sometimes prone to malignancy. Clinical manifestations of mucocele of the appendix are nonspecific. In a number of patients, this disease causes pain in the right abdomen, more often pulling, intermittent. However, the disease is often asymptomatic. In this regard, diagnosis is established only during performing an operation, most often, regarding acute appendicitis. Nevertheless, instrumental diagnostic methods such as ultrasound and computed tomography of the abdominal and pelvic organs make it possible to suspect mucocele. Despite the frequent asymptomatic, non-aggressive course, a number of life-threatening complications can become the outcome of the mucocele of the vermiform appendix. The most formidable complication is the rupture of the appendix with mucus entering free abdominal cavity, followed by the development of peritoneal pseudomyxoma due to implantation of mucus-forming cells. The only option for radical treatment of the mucocele of the appendix is a surgical intervention. A presented clinical case demonstrates the difficulties of diagnosis, as well as the features of surgical treatment of a patient with a mucocele of the appendix.

scholarly journals AUTOPSY FEATURES AT THE ACUTE DESTRUCTIVE PANCREATITIS

2020 ◽  
Vol 28 (2) ◽  
pp. 48-54
Author(s):  
Al'fiya K. Imayeva ◽  
Tagir I. Mustafin
Keyword(s):  
Acute Pancreatitis ◽  
Transverse Colon ◽  
Infectious Agent ◽  
Pathological Process ◽  
Postmortem Examination ◽  
Retroperitoneal Space ◽  
Contrast Study ◽  
Type I ◽  
Type Iii ◽  
The Right

In all variants of the destructive form of pancreatitis, the involvement of adipose tissue of both para-pancreatic and distant localization was noted. In this case, it is necessary to improve the pathological diagnosis of acute destructive pancreatitis. The aim of the study was to develop new techniques for postmortem examination of those who died from complications of acute pancreatitis. Pathological studies were supplemented by the methods proposed by the authors, which made it possible to clarify the spread of the infectious agent through the retroperitoneal tissue. The scheme proposed by the authors for recording changes in the tissue of the pancreas and surrounding tissues after a contrast study made it possible to clarify the main ways of propagation of the purulent-necrotic process along the retroperitoneal tissue. The results of postmortem examination of 67 deaths from complications of acute pancreatitis are presented. Based on the study, 5 types of acute destructive pancreatitis were identified. In type I, the pathological process involves the right half of the retroperitoneal tissue, including the mesentery root of the small intestine, the para-pancreatic region, the right para-kidney and sub-hepatic space. The second type is characterized by the presence of inflammatory and destructive changes in the fiber of the right lateral canal, the actual retroperitoneal space on the right and the mesentery root of the transverse colon. Purulent-necrotic changes in para-pancreatic, left perineal tissue, mesentery of the transverse colon, also in peritoneum were typical for type III acute destructive pancreatitis. For type IV disease, in addition to areas of involvement as in type III, involvement of the pelvic tissue and the left sections of the retroperitoneal space itself were noted. The spread of the infectious agent to both the right and left parts of the retroperitoneal tissue was defined as type V acute destructive pancreatitis.

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