Solitary Neurofibroma Of The Spermatic Cord: A Case Report.

We report the ultrasound, computerized tomography, positron emission tomography and magnetic resonance imaging findings of a 38-year-old man with a biopsy proven solitary neurofibroma of the spermatic cord. Solitary neurofibromas of the male genital tract are exceedingly rare benign peripheral nerve sheath neoplasms composed of Schwann cells and fibroblasts. In contrast to schwannomas they are not bound by a capsule thus allowing infiltration between the nerve fascicles. Although they are benign lesions whose potential for malignant degeneration is very low, especially in the absence of neurofibromatosis type 1, accurate diagnosis is important as neurofibromas in this location can cause significant morbidity and psychological distress. Despite the extensive differential diagnosis of masses in the male inguinal canal, including both benign and malignant entities, a diagnosis of benign peripheral nerve sheath tumor can be potentially suggested based on imaging, particularly if MRI is performed. Surgical resection is the treatment of choice and the final diagnosis should be provided by histopathology, as was the case with this patient

Emergency surgery for Meckel's diverticulum

The current work attempts to highlight the various life threatening complications of Meckel's diverticulum and to present the surgical strategies used in the emergency conditions so far in the form of a review of the works presented in the literature. Our aim behind this presentation is to cover the possible indications, methods, their complications and the outcome of these surgical techniques. For this, we made an extensive literature search using Google and Pubmed with the words-"Meckel's diverticulum", "Complications", "Management" and "Emergency surgery". All the relevant articles containing the surgical aspects of symptomatic Meckel's diverticulum till May 2008 were collected and analyzed. Meckel's diverticulum is the remains of the prenatal yolkstalk (Vitellointestinal duct). Although it generally remains silent but life threatening complications may arise making it an important structure for having a detailed knowledge of its anatomical and pathophysiological properties to deal with such complications

Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>In 1809, Johann Friedrich Meckel described the embryology of a small bowel diverticulum, which now bears his name. Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, with a prevalence ranging from 1% to 4% of the population. The majority are clinically silent and are incidentally identified at surgery or at autopsy. The lifetime risk of complications is estimated at 4%, with most of these complications occurring in adults. It is these cases that can cause problems for the clinician, as the diagnosis can be elusive and the consequences extremely serious.</p> <p>Case presentation</p> <p>We present the case of a 68-year-old Caucasian man with axial torsion of a Meckel's diverticulum around its base, a rare complication. He presented with acute, severe abdominal pain, and a clinical diagnosis of perforated acute appendicitis was made. Laparotomy revealed a torted Meckel's diverticulum with distal necrosis and perforation, which was resected. His recovery was uncomplicated, and he was discharged to home six days post-operatively.</p> <p>Conclusion</p> <p>Torsion is an extremely rare complication of Meckel's diverticulum. Its presentation can be elusive, and it can mimic a number of different, more common intra-abdominal pathologies. Imaging appears to be an unreliable diagnostic tool, and the diagnosis is usually made intra-operatively. Factors pre-disposing these patients to axial torsion of Meckel's diverticulum include the presence of mesodiverticular bands, a narrow base, excessive length, and associated neoplastic growth or inflammation of the diverticulum. The importance of searching for a diseased Meckel's diverticulum at laparotomy in appropriate circumstances is highlighted. Once identified, prompt surgical excision generally leads to an uncomplicated recovery.</p

Rol del ultrasonido abdominal en el diagnóstico de intususcepción en relación con las demás técnicas de imagen

OBJETIVO: Demostrar la sensibilidad y especificidad de la ultrasonografía abdominal en relación a las diferentes técnicas de imagen en el diagnóstico temprano de Intususcepción y su influencia en el tratamiento y por ende en la morbimortalidad del paciente. MATERIAL Y MÉTODO: Se utilizaron ecógrafos multifrecuenciales marca Phillips, Tomografía Computarizada Helicoidal, y Equipo de RX. Analógico de 500 MA, se recopilaron datos provenientes de las Historias Clínicas. El método usado fue descriptivo-transversal, comparativo y retrospectivo. Se usaron en este estudio los lineamientos de la Organización Mundial de la Salud. RESULTADO: Fueron recopilados datos provenientes de 540 pacientes atendidos entre los años 2002-2012 en el Hospital María Auxiliadora que ingresaron con el diagnostico de obstrucción intestinal de los cuales 50 pacientes entre lactantes, niños y adultos tuvieron diagnóstico presuntivo de Intususcepción. Se realizaron 42 ecografías abdominales (84%), 27 radiografías de abdomen simple (54%) ,12 tomografías computarizadas (24%) realizándose solo 2 tránsitos intestinales (4%) cuyos resultados fueron confrontados con los resultados postoperatorios y los hallazgos anatomopatológicos de los sustratos anatómicos en las muestras halladas. El tiempo de enfermedad y el retardo en el diagnóstico fue determinante en el desarrollo de complicaciones tales como necrosis y perforación intestinal así como el tipo de cirugía utilizada como desinvaginación, resección intestinal y anastomosis. CONCLUSIÓN: Se demostró que la Ecografía y la Tomografía Computarizada tienen una alta sensibilidad y especificidad en el diagnóstico de Intususcepción en relación a las demás técnicas de imagen

Chronic Ileocecal Intussusception Secondary to Non-Hodgkins Lymphoma

Chronic intussusception is a distinct clinical entity which is unfortunately poorly recognized due to its atypical presentation. A 5½ year old female  patient presented with a 5 month history of abdominal pain associated with occasional vomiting, anorexia and progressive weight loss. 5 days prior to admission she developed loose, non-mucoid, non-blood stained stool associated with refusal to feed and irritability. Systemic examination, an abdominal ultrasound and abdominal radiograph were non-contributory.During treatment for malnutrition and dehydration she was noted to clinically improve, however, 6 days post-admission she developed  abdominal pain, a palpable sausage-shaped abdominal mass, and currant-jelly stool. Emergency laparotomy revealed an ileocecal  intussusception with oedematous nonviable, aperistaltic terminal ileum and mobile cecum, a cecal mass and mesenteric lymphadenopathy was found. We performed a right hemicolectomy with an ileocolic anastomosis and mesenteric lymph node sampling. Histology results revealed the cecal  mass as a lymphoproliferative neoplasm with a diagnostic consideration of intermediate to large cell Non-Hodgkins Lymphoma; and reactive  hyperplasia of mesenteric lymph nodes. There is need for a highindex of suspicion in children with non-specific abdominal symptoms for which no cause can be found. Further, all suspicious masses should haveimmunohistological histological evaluation.Key Words: Chronic Ileocecal Intussusception, Non Hodgkins Lymphom

A Rare Case of Sigmoid Intussusception due to Sigmoid Diverticula in a Patient with Concomitant Extensive Small Bowel Diverticula

Small intestinal diverticula is a rare occurrence, and their surgical management remains controversial due to the lack of a recognized classification system. Complications such as perforation and obstruction are treated surgically. Their etiology remains nebulous but theories such as damage to the Auerbach’s nerve plexus have been advanced as a possible cause. The concomitant presence of a sigmoid intussusception due to diverticular disease in the same patient is truly a rare occurrence. The vast majority of colonic intussusception is due to malignancy and a benign etiology remains elusive. The reported cases of benign causes include a lipoma and benign lymphadenopathy. We believe this to be the first such case report of a colonic diverticulum causing an intussusception. Despite an exploratory laparotomy of less than sixty minutes, the patient demised in the intensive care unit following an occipital lobe stroke. We believe this case of sigmoid intussusception with concomitant small intestinal diverticula to be the first such case report of its kind in English-language scientific publications

Formas atípicas de presentación en pacientes con divertículo de Meckel: reporte de casos.

Se presentan 5 casos de pacientes con divertículo de Meckel con presentación atípica, atendidos en 2 hospitales de la ciudad de Chiclayo, Perú, entre los meses de enero a abril del 2015. El divertículo de Meckel es un vestigio embrionario del conducto onfalomesentérico, el cual normalmente regresiona en forma completa entre la quinta y la séptima semana; se localiza en el borde antimesentérico del íleon y aproximadamente a 60 cm de la válvula ileocecal

Severe pulmonary tuberculosis complicating Ileocecal intussusception due to intestinal tuberculosis: a case report

Adult intussusception is a rare clinical entity that is most often caused by a tumor, such as a lipoma, adenoma, or malignant tumor. A case of adult intussusception due to intestinal tuberculosis of the ileocecal region is reported. There are few cases of intussusception due to intestinal tuberculosis