1/18. Bowel entrapment within pelvic fractures: a case report and review of the literature.Bowel entrapment within a pelvic fracture is a rarely reported but potentially fatal complication. diagnosis is often delayed due to difficulty in differentiating entrapment from the more common adynamic ileus. Computed tomography of the abdomen and pelvis with enteric contrast can be useful in making the diagnosis. We report an unusual case of bowel entrapment within a pelvic fracture presenting as a colocutaneous fistula in a patient with no prior symptoms that suggested a bowel injury. This report expands the realm of presentation of this rare occult bowel injury.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
2/18. Giant sigmoid diverticulum: a report of three cases.The imaging appearances of three patients with a giant sigmoid diverticulum are described. The prominent feature was a large gaseous lucency noted in the lower abdomen on plain radiographs. Computed tomography (CT) was undertaken in two cases and in these a large gas filled collection was identified containing a small quantity of fluid. In the third case the collection was aspirated, contrast medium injected and a communication with the large bowel demonstrated. The condition is uncommon and needs to be distinguished from sigmoid and caecal volvulus.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
3/18. Delayed colon perforation after palliative treatment for rectal carcinoma with bare rectal stent: a case report.In order to relieve mechanical obstruction caused by rectal carcinoma, a bare rectal stent was inserted in the sigmoid colon of a 70-year-old female. The procedure was successful, and for one month the patient made good progress. She then complained of abdominal pain, however, and plain radiographs of the chest and abdomen revealed the presence of free gas in the subdiaphragmatic area. Surgical findings showed that a spur at the proximal end of the bare rectal stent had penetrated the rectal mucosal wall. After placing a bare rectal stent for the palliative treatment of colorectal carcinoma, close follow-up to detect possible perforation of the bowel wall is necessary.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
4/18. Perforated congenital diverticulum of the sigmoid colon.A case of perforation of a congenital sigmoid diverticulum producing diffuse peritonitis in a 4-year-old boy is presented. physical examination showed an acute abdomen despite a normal computed tomography study. Successful surgical treatment was achieved by excision of the diverticulum, adjacent bowel, and an end-to-end anastomosis.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
5/18. Giant diverticulum of the colon: report of two new cases and review of the literature.Diverticulosis coli affects more than one in three individuals older than 65 in the western world. Giant diverticulum of the colon is an extremely rare complication of diverticular disease; only 113 cases, mostly situated in the colon sigmoideum, have been reported in the world literature. Two new cases of giant diverticulum of the colon sigmoideum, with totally different clinical presentation, diagnosis, and management, are reported-one being the cause of chronic anemia and the other presenting as an acute abdomen. Based on a review of the literature, an update on symptomatology, diagnosis, pathogenesis, and therapeutical options of this rare disorder is provided.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
6/18. Sigmoid colon perforation as an unusual complication of Behcet's syndrome: report of a case.A 47-year-old man with long-standing Behcet's syndrome presented with an acute abdomen, and was found to have perforation of the sigmoid colon. laparotomy revealed gangrenous changes in the sigmoid colon and perforation in the center of the affected segment. This is a very rare complication of Behcet's disease, and we report this case to stress the importance of performing careful abdominal examination while evaluating patients with Behcet's disease.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
7/18. Mesenteric pseudocyst of the sigmoid colon.A 31-year-old woman with right lower abdominal pain was hospitalized. palpation revealed both tenderness and rebound tenderness in the right lower quadrant of her abdomen. Abdominal ultrasonography (US) indicated a multilocular cystic mass on the right side of the pelvic area, and a computed tomography (CT) scan showed a low-density mass measuring 7 cm in diameter. Torsion of the pedicle of a right ovarian cyst was suspected, and emergency laparotomy was performed. At operation, however, the uterus and both ovaries appeared normal, and exploration revealed a yellow-reddish cystic mass, approximately 10 cm in size, in the subserosa of the sigmoid colon. The mass was excised together with a 10-cm segment of the sigmoid colon. Macroscopically, it was a multilocular cyst, measuring 10 x 10 cm in size, and it contained white gelatinous fluid. Histological examination showed the cyst wall to be composed of neutrophils, lymphocytes, fibrin, and fibroblasts, but neither a specific endothelial lining nor proliferating lining was detected. The final pathological diagnosis was a mesenteric pseudocyst. Mesenteric pseudocysts are rare, and only 14 cases have been reported previously in the Japanese literature. Emergency operation was performed in 3 patients, including our own. The etiology of these three pseudocysts (manifested by acute abdomen) was unknown. We suspect that inflammation spread and injured lymph vessels, causing lymph to leak out and pool under the subserosal layer.- - - - - - - - - - ranking = 2keywords = abdomen (Clic here for more details about this article) |
8/18. empyema resulting from a true colopleural fistula complicating a perforated sigmoid diverticulum.Empyemas developing after traumatic rupture of intraabdominal organs have been previously reported. We report a case of a true nontraumatic colopleural fistula following surgery for spontaneous rupture of a sigmoid diverticulum. The diagnosis was suspected by the presence of an air-containing tract seen in a computerized tomogram of chest and abdomen and was established with a contrast study. The empyema cavity was initially drained, followed by a laparotomy and fistulectomy with primary large bowel anastomosis and loop ileostomy. Although rare, colopleural fistulas present a diagnostic challenge and delayed management can lead to increased morbidity.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
9/18. Gigantic post-traumatic pseudocyst of sigmoid mesentery.A 29-year-old man presented with dull abdominal pain and a lump occupying almost the entire abdomen, four months after a fall from a height. ultrasonography revealed a cystic lesion with debris occupying almost the entire abdomen. Diagnostic tap revealed brownish fluid. Exploration revealed a huge thick-walled cyst of the sigmoid mesocolon, which could be enucleated out entirely. histology suggested it to be a false cyst.- - - - - - - - - - ranking = 2keywords = abdomen (Clic here for more details about this article) |
10/18. Laparoscopic resection of a torsioned appendix epiploica in a previously appendectomized patient.Torsion of the appendices epiploicae is a rare condition that may present with acute abdominal pain and mimics appendicitis. We report a 20-year-old previously appendectomized man presenting with right lower abdominal quadrant pain. Abdominal ultrasonography showed a localized omental thickening in the right paracolic region. Contrast-enhanced computed tomography revealed well-circumscribed fatty tissue adjacent to the cecum with heterogeneous hyperdense infiltration of the mesentery near the sigmoid colon. Diagnostic laparoscopy revealed 2-cm diameter torsioned and edematous fatty tissue floating on the omentum in the right lower quadrant. The torsioned mass was elevated, and a thick stalk was seen to be connecting the fatty tissue to the sigmoid colon. At this point, the torsioned fatty tissue was considered as a sigmoidal appendix epiploica that was elongated and neighboring on the previously operated-on region. The lesion was removed by laparoscopic means using 3 ports. Grossly, fat necrosis and internal bleeding were seen. Histopathologic analysis of the resected tissue demonstrated adipose tissue surrounded by fibrotic inflammatory changes with marked infiltration of numerous lymphocytes and histiocytes. In conclusion, torsion of appendices epiploicae should be included in the differential diagnosis of acute abdomen when evaluating patients with right lower quadrant pain and a history of appendectomy. Laparoscopic surgery provides definite diagnosis and prevents unnecessary open procedures for such lesions leading to peritoneal irritation.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
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