1/5. Obstructing giant colonic diverticulum.We report the second case of an obstructing true colonic diverticulum. Of the 103 cases of giant sigmoid diverticulum found in the literature, 13% have been reported as true giant sigmoid diverticulum, ie, containing all layers of the colonic wall. Our 75-year-old patient had clinical symptoms for only 6 months, and endoscopy revealed an almost totally obstructing mass 20 cm from the anus. Surgical resection of the sigmoid colon with a primary anastomosis resolved all of the patient's obstructive symptoms. A flap-valve mechanism was the cause of this true giant colonic diverticulum. Microscopic examination of the diverticulum wall revealed all normal layers of colon wall.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/5. Gigantic jejunal leiomyosarcoma.Jejunal leiomyosarcoma is a rare neoplasm. We report a case of gigantic leiomyosarcoma of the jejunum in a 30-year old man who presented with abdominal distension, pain and constipation. Computerized tomography scan revealed a giant tumor filling the entire abdominal cavity. Fine needle aspiration cytology was suspicious. At laparotomy, a huge jejunal leiomyosarcoma measuring 30 x 25 x 19 cm and weighing 13 kg was completely excised. To the best of our knowledge, this is the first case of a giant jejunal leiomyosarcoma.- - - - - - - - - - ranking = 0.28571428571429keywords = giant (Clic here for more details about this article) |
3/5. Giant fecaloma with idiopathic sigmoid megacolon: report of a case and review of the literature.PURPOSE: fecal impaction is a common condition, and " fecaloma" is an extreme variety of impaction. This is a report of a giant, solitary, and stubborn fecaloma not responding to nonoperative management. A surgical intervention for uncomplicated fecal impaction is rarely needed and reported in the literature. METHOD: A 39-year-old male patient with constipation presented with a firm, mobile, abdominal mass of six-months duration. Investigations revealed an isolated, giant fecaloma in a redundant sigmoid megacolon. After all the conservative measures were unsuccessful in evacuating the stubborn impaction, he was treated by sigmoid colectomy and primary anastomosis. CONCLUSION: A timely surgical intervention in recalcitrant fecal impactions may prevent possible stercoral ulcer perforation with a high mortality.- - - - - - - - - - ranking = 0.28571428571429keywords = giant (Clic here for more details about this article) |
4/5. Giant sigmoid diverticulum causing colonic and urinary obstruction.Diverticulosis of the colon is a fairly common disease, but a solitary giant diverticulum is relatively rare. This case presented with symptoms of urinary and bowel obstruction.- - - - - - - - - - ranking = 0.14285714285714keywords = giant (Clic here for more details about this article) |
5/5. Intestinal neuronal dysplasia in twins.Intestinal neuronal dysplasia (IND) has been described proximal to the aganglionic segment in Hirschsprung's disease and less frequently as an isolated condition. Familial occurrence of IND is rare. We report a case of monozygotic twins affected with IND. One-year-old male monozygotic twins presented with a history of chronic constipation and abdominal distension since birth. At presentation, both twins had fecal impaction with palpable fecal-filled loops of bowel. barium enema in both patients showed gross fecal loading of the sigmoid colon and rectum. Delayed films taken at 48 h showed marked barium retention. suction rectal biopsy specimens examined by acetylcholinesterase (AChE) histochemistry in both patients showed moderately increased AChE-positive nerve fibers in the lamina propria, muscularis mucosae, and around submucosal blood vessels, as well as hyperplasia of submucous plexus with formation of giant ganglia. Both children underwent extended internal sphincter myectomy. Six months later, both patients had normal bowel function. The occurrence of IND in twins suggests that genetic factors are involved in the etiology of this disease.- - - - - - - - - - ranking = 0.14285714285714keywords = giant (Clic here for more details about this article) |