Mediastinal extension of a complicated pancreatic pseudocyst; a case report and literature review

BACKGROUND: Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. CASE PRESENTATION: This case report describes the management of a difficult case of pancreatic pseudocyst with a mediastinal extension in a patient having chronic pancreatitis. Different management strategies were used until complete resolution of this complex pseudocyst occurred using open surgical cystogastrostomy. CONCLUSION: Despite the availablity of different minimally invasive techniques to treat pancreatic pseudocysts, management of complex mediastinal pseudocyst may still require open surgical drainage procedures

Ruptured appendiceal cystadenoma presenting as right inguinal hernia in a patient with left colon cancer: A case report and review of literature

BACKGROUND: Mucoceles resulting from cystadenomas of the appendix are uncommon. Although rare, rupture of the mucoceles can occur with or without causing any abdominal complaint. There are several reports associating colonic malignancy with cystadenomas of the appendix. Herein, we report an unusual and interesting case of right inguinal hernia associated with left colon cancer. CASE PRESENTATION: A case of ruptured mucocele resulting from cystadenoma of the appendix was presented as right inguinal hernia in a 70-year-old male. The patient underwent colonoscopy, x-ray, ultrasound and computed tomography. Localized pseudomyxoma peritonei associated with adenocarcinoma of the descending colon was diagnosed. The patient underwent segmental resection of the colon, appendectomy, debridement of pseudomyxoma and closure of the internal ring of right inguinal canal. He is free of symptoms in one year follow-up. CONCLUSION: Synchronous colon cancer may occur in patients with appendiceal mucoceles. In such patients, the colon should be investigated and colonoscopy can be performed meticulously in cases of ruptured mucoceles and localized pseudomyxoma peritonei. Surgical intervention is the current choice of management

Challenges in planning and initiating a randomized clinical study of sphincter of Oddi dysfunction

Sphincter of Oddi dysfunction (SOD) is a controversial topic, especially in patients with no objective findings on laboratory or imaging studies (SOD type III). The value of ERCP manometry with sphincterotomy is unproven and carries significant risks

Can patient and pain characteristics predict manometric sphincter of Oddi dysfunction in patients with clinically suspected sphincter of Oddi dysfunction?

Biliopancreatic-type postcholecystectomy pain, without significant abnormalities on imaging and laboratory test results, has been categorized as “suspected” sphincter of Oddi dysfunction (SOD) type III. Clinical predictors of “manometric” SOD are important to avoid unnecessary ERCP, but are unknown

Laparoscopy using a flexible endoscope

40 patients ont subi une laparoscopie diagnostique à la fois avec un instrument rigide et un fibroscope Olympus GIF P2 non modifié. L'usage du fibroscope comme instrument de laparoscopie a été évalué du point de vue sécurité et maniabilité. Les avantages du fibroscope comportent l'accroissement des surfaces explorables la facilité de la biopsie péritonéale, de la cytologie avec brossage et une flexibilité favorable au contournement des adhérences. Aucune complication d'ordre mécanique ou infectieux n'a été notée. Le fibroscope laparoscopique flexible s'avère un instrument complémentaire de l'appareil rigide et pourrait éventuellement le remplacer en partie comme dans d'autres domaines de l'endoscopie