1/31. Repair of a giant inguinoscrotal hernia.We present a case of a long-standing, giant inguinoscrotal hernia extending to the patient's knees, complicated by intestinal obstruction. Initial management involved conservative treatment of the intestinal obstruction and optimising the patient's general condition. Surgical treatment included debulking the contents of the hernia sac by performing a right hemicolectomy and a small bowel resection, and reconstruction of the abdominal wall using Marlex mesh and a tensor fasciae latae flap. Although abdominal wall reconstruction for massive ventral or incisional herniae is well reported, inguinoscrotal herniae of this magnitude are much rarer and pose additional problems, which are discussed in this paper.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/31. 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 = 1.4keywords = giant (Clic here for more details about this article) |
3/31. Uroepithelium in a colonic diverticulum.Giant colonic diverticula are rare entities and often present in adulthood as acute diverticulitis. The authors present a case of giant colonic pseudodiverticulum lined with uroepithelium causing bowel obstruction in a neonate. The presence of uroepithelium in a colonic pseudodiverticuium remains unexplained and to the authors' knowledge unreported. This heterotopic tissue may be a result of an embryonic rest or could be urachal in origin adhering initially to the colon and eventually detaching from the umbilicus. These lesions should be resected because of the risk of infection, perforation, or obstruction.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
4/31. Ulcerative disease of the colon proximal to partially obstructive lesions: report of two cases and review of the literature.carcinoma complicating idiopathic ulcerative colitis is well known. Conversely, acute colitis complicating obstructing carcinomas and other partially obstructing lesions of the colon has not been recognized until recently. The present study reports two cases of colitis secondary to obstruction: 1) a giant ulcer with colitis proximal to partially obstruction diverticulitis of the sigmoid colon, and 2) colitis proximal to obstructing carcinoma of the sigmoid colon. The purpose of this report is to document these cases and review the literature on this variety of colitis to facilitate its recognition and subsequent correct treatment. An unawareness of this entity prejudices the anastomosis and results in anastomotic complications (approximately 25 per cent), with significant morbidity and mortality.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
5/31. 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 = 0.2keywords = giant (Clic here for more details about this article) |
6/31. Torsion of a giant mesenteric lipoma.Mesenteric lipoma is a rare benign neoplastic condition that can grow to be very large and mimic other midgut fatty tumors. These benign tumors can cause various gastrointestinal symptoms such as obstruction and abdominal pain. We report the case of a 9-year-old boy who presented with a small bowel obstruction caused by torsion of a large mesenteric lipoma. This is an important but unusual tumor and should be considered in the differential of fatty lesions within the mesentery.- - - - - - - - - - ranking = 0.8keywords = giant (Clic here for more details about this article) |
7/31. Giant duodenal gallstone presenting as gastric outlet obstruction: Bouveret's syndrome.In a 91 year old woman with nausea and vomiting, the diagnosis of Bouveret's syndrome was considered when a barium meal disclosed a cholecystoduodenal fistula and a giant filling defect in the duodenum. Because of her age and underlying medical illness, operative therapy was initially deferred. Repeated attempts to remove the intermittently obstructing duodenal gallstone endoscopically were unsuccessful using both endoscopic retrograde cholangiopancreatography retrieval baskets and an endoscopic mechanical lithotripter. The patient was referred for definitive operative therapy, and was discharged after a successful and uneventful enterolithotomy.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
8/31. Sclerosing encapsulating peritonitis: differential diagnosis to peritoneal encapsulation and abdominal cocoon--a case report.A 59 year old man presented with symptoms of partial bowel obstruction. Small bowel x-ray studies did not allow to identify the nature of the intestinal process in the upper ileum. At laparotomy small bowel encapsulation with a whitish membrane was encountered. Despite partial removal of this membrane small bowel obstruction persisted and two weeks postoperatively the patient died of peritonitis and cardiac insufficiency. autopsy findings revealed massive fibrous adhesions in the abdomen with granulomatous inflammation. The presence of foreign body giant cells and bifringent crystals were characteristic for talcum powder. The latter suggested a causal role of an appendectomy 45 years earlier. The diagnosis of sclerosing encapsulating peritonitis as established in our patient needs to be separated from peritoneal encapsulation, a congenital malformation, and abdominal cocoon, which contains histological elements of inflammation. This case report should draw attention to these entities in the differential diagnosis and surgical management of small bowel obstruction.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
9/31. Contrast enema depiction of small-bowel volvulus in complicated neonatal bowel obstruction.About one-half of patients with meconium ileus (MI) present with a complication such as volvulus, atresia, meconium peritonitis or giant cystic meconium peritonitis. The treatment of these complications requires surgery. However, the preoperative diagnosis of complicated MI is difficult. We describe two neonates with complicated small-bowel obstruction, one with MI related to cystic fibrosis and the other not related to cystic fibrosis. In both, contrast enema depicted a spiral appearance of the distal small bowel, which at surgery proved to be the result of volvulus associated with antenatal bowel perforation. This appearance of the small bowel on contrast enema in this clinical setting has not been previously described. The recognition of this spiral appearance of the distal small bowel suggests the need for surgery.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
10/31. Colonic obstruction due to giant inflammatory polyposis in a patient with ulcerative colitis.A 32-year-old Japanese woman with a 14-month history of ulcerative colitis (UC), pancolitis type, was referred to our institution, because of abdominal distention. Plain abdominal X-ray and computed tomography (CT) showed marked dilatation of the right side of the colon. The patient was treated by immediate total colectomy, with the diagnosis of toxic megacolon. Macroscopically, there was a constricting lesion with giant polyposis in the middle part of the transverse colon. Histologically, there was transmural inflammation with a thickened proper muscular layer overlaid by inflammatory polyposis. This case suggests that giant polyposis in UC patients may result in severe stenosis and that such a condition should not be misinterpreted as toxic megacolon or as colitic cancer.- - - - - - - - - - ranking = 1.2keywords = giant (Clic here for more details about this article) |
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