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Frontiers in Oncology 2022Extragonadal yolk sac tumor (YST) of peritoneum is a rare malignancy.
BACKGROUND
Extragonadal yolk sac tumor (YST) of peritoneum is a rare malignancy.
CASE DESCRIPTION
A 37-year-old Chinese woman was admitted to hospital with a 3-month abdominal pain 4 years ago. Alpha-fetoprotein was 228,499.0 ng/mL. Computed tomography scan revealed a massive mass in the left lower abdomen. Exploratory laparotomy exposed a huge mesenteric mass. Then, mesenteric tumor resection, partial sigmoidectomy, and single-lumen fistula of sigmoid colon were performed. Postoperative pathologic diagnosis reported a stage IV mesenteric YST. After surgery, the patient received 6 courses of BEP (bleomycin, etoposide, and cisplatin) chemotherapy. Seven months later, the patient underwent stoma reversion of sigmoid colon and received another 2 courses of BEP chemotherapy. Three months after the last chemotherapy, liver metastases were diagnosed. She subsequently underwent 3 surgeries, radiotherapy for liver metastases, and multiple tiers of palliative chemotherapies, including TP (docetaxel and carboplatin), VIP (ifosfamide, cisplatin, and etoposide), TIP (paclitaxel, ifosfamide, and cisplatin), and so on. After the third surgery (left hepatic lesion resection and right iliac lymph node resection), she received 4 cyclic chemotherapies of BEP´ (boanmycin, etoposide, and cisplatin) without pulmonary toxic side effects.
CONCLUSION
Postoperative histopathology and immunohistochemistry are gold standards for the diagnosis of peritoneal YST. The standard first-line treatment is surgery plus BEP chemotherapy. Second-line therapy regimens and above, including VIP and TIP, improve the prognosis of recurrent germ cell tumors. This relapsed and refractory patient with peritoneal YST benefits from the secondary BEP´ chemotherapy.
PubMed: 36016622
DOI: 10.3389/fonc.2022.928234 -
Case Reports in Surgery 2022Peritoneal encapsulation (PE) is a rare congenital malformation in which the small intestine is partially or totally encased in a supplementary peritoneal sac. PE is...
Peritoneal encapsulation (PE) is a rare congenital malformation in which the small intestine is partially or totally encased in a supplementary peritoneal sac. PE is usually asymptomatic; therefore, it is one of the rarest etiologies of bowel obstruction. Our patient presented at the age of 55 with no prior surgical history and a 3-day history of abdominal pain associated with nausea, vomiting, belching, and constipation. An obstruction secondary to an internal hernia-visualized on a CT scan-was suspected as the initial etiology. On exploratory laparotomy, the small bowel was covered by a thick adherent sac. These findings are consistent with PE, a condition that deserves recognition among clinicians worldwide. Intraoperatively, the sac was excised, and the small bowel was pulled up to the peritoneal cavity starting from the ileocecal valve to the duodenojejunal junction. In the postoperative period, the patient was managed with intravenous fluids, analgesics, and antibiotics. Wound infection was the only postoperative complication. Otherwise, all symptoms subsided, and the patient improved and was discharged home on the 8th postoperative day.
PubMed: 35992022
DOI: 10.1155/2022/7851130 -
Radiology Case Reports Oct 2022An internal hernia is a protrusion of a visceral organ through a peritoneal or mesenteric opening within the abdominal or pelvic cavities. Internal hernias may present...
An internal hernia is a protrusion of a visceral organ through a peritoneal or mesenteric opening within the abdominal or pelvic cavities. Internal hernias may present with a wide range of symptoms from mild digestive pain to acute abdomen. Internal hernias have a high morbidity and mortality rate often due to delayed diagnosis and progression of bowel obstruction to bowel ischemia or infarction. High clinical suspicion, cross-sectional imaging, and early surgical intervention are important to prevent life-threatening complications. Here, we report an internal hernia of the cecum through the foramen of Winslow and into the lesser sac with classic CT findings. The patient underwent a successful exploratory laparotomy and resection.
PubMed: 35982718
DOI: 10.1016/j.radcr.2022.07.093 -
An adolescent with ileum herniation through foramen of winslow: A case report and literature review.Nigerian Journal of Clinical Practice Aug 2022Herniation through foramen of Winslow is a relatively rare group of hernias characterized by protrusion of the abdominal contents into the lesser sac. To our knowledge,... (Review)
Review
BACKGROUND
Herniation through foramen of Winslow is a relatively rare group of hernias characterized by protrusion of the abdominal contents into the lesser sac. To our knowledge, this is the youngest and the only reported case related to adolescents in the last five years.
CASE PRESENTATION
A 15-year-old male patient presented to our emergency department after experiencing 4 hours of acute dull upper abdominal pain. We diagnosed the patient with herniation through foramen of Winslow by computed tomography (CT) and other complementary diagnostic methods. After a 3-trocar laparoscopic procedure, the hernia was successfully repositioned and no bowel resection was required. The patient was discharged on the fourth postoperative day without complications. He was no recurrence six months after operation.
CONCLUSIONS
Through the review of the literature, it is clear that herniation through foramen of Winslow (HFW) is a more challenging condition to diagnose preoperatively, which can be achieved with the help of complementary diagnostics especially CT. As a category of diseases with a very low postoperative recurrence rate, clinical experience tells us that only three-trocar laparoscopic surgery can successfully return HFW.
Topics: Abdomen, Acute; Adolescent; Hernia; Herniorrhaphy; Humans; Ileum; Laparoscopy; Male; Peritoneal Cavity
PubMed: 35975390
DOI: 10.4103/njcp.njcp_1778_21 -
Journal of Minimal Access Surgery 2023Minimally invasive surgeries for inguinal hernia repair have been reduced post-operative morbidity. However, certain complications such as seroma formation are...
BACKGROUND
Minimally invasive surgeries for inguinal hernia repair have been reduced post-operative morbidity. However, certain complications such as seroma formation are unavoidable. In this study, we introduce a newer technique of reducing seroma formation by fenestration of the pseudo-sac (thickened transversalis fascia) in patients undergoing laparoscopic hernia repair for uncomplicated direct inguinal hernia.
PATIENTS AND METHODS
A randomised, controlled pilot study was conducted from January 2019 to December 2020 for the patients undergoing laparoscopic hernia repair for uncomplicated direct inguinal hernia. Study participants were randomised into interventional group and control groups. Demographics, operative duration and complications including post-operative pain and seroma on days 1, 10 and 30 were analysed between both the groups.
RESULTS
A total of 20 cases with 30 hernias were included in the study. Demographic data were comparable between the two groups. The intervention group showed a statistically significant decrease in the incidence of seroma formation on the post-operative day 10 (13.3% vs. 46.6%, P = 0.046). The mean volume of seroma on day 10 was also less compared to the non-fenestration group (2.5 vs. 6.58 ml, P = 0.048). After the 30 day, no patient had a presence of seroma. There were no statistically significant differences in terms of mean operative duration, post-operative pain and other complications.
CONCLUSION
Fenestration of pseudo-sac in laparoscopic hernia repair for uncomplicated direct inguinal hernia is a simple and effective technique. It has reduced the incidence and volume of seroma formation without any increased risk of infection, acute or chronic pain and recurrence.
PubMed: 35915521
DOI: 10.4103/jmas.jmas_391_21 -
Frontiers in Surgery 2022Primary hepatic neuroendocrine carcinoma (PHNEC) manifests as a rare type of liver tumor. PHNEC is not specifically clinical or radiographical and is often misdiagnosed...
Primary hepatic neuroendocrine carcinoma (PHNEC) manifests as a rare type of liver tumor. PHNEC is not specifically clinical or radiographical and is often misdiagnosed and mistreated. Here, we present a case report of PHNEC in a 50-year-old woman who was admitted to our department with concealed pain in the right upper abdomen. The initial diagnosis was a probable hepatic space-occupying lesion with tumor bleeding. The patient was subjected to a partial right hemihepatectomy, cholecystectomy, partial resection of the lower lobe of the right lung, partial resection of the diaphragm, and resection of the right perirenal fat sac to alleviate her symptoms. After surgery, gene sequencing was performed to determine the possible cause of the condition. However, five months after discharge, the patient was hospitalized again because of retroperitoneal and peritoneal multiple metastases. Nine months after surgery, the patient died. This case is likely to aid in furthering our understanding of PHNEC to improve the future diagnosis and treatment of this disease.
PubMed: 35910478
DOI: 10.3389/fsurg.2022.920276 -
Journal of Surgical Case Reports Jul 2022Hydrocele of the canal of Nuck is a rare condition seen in younger females which is an extension of the peritoneum into the inguinal canal. Incomplete proximal...
Hydrocele of the canal of Nuck is a rare condition seen in younger females which is an extension of the peritoneum into the inguinal canal. Incomplete proximal obliteration and collection of serous fluid in the sac leads to the formation of a hydrocele of the canal of Nuck. A 28-year-old woman presented with swelling in her right groin for 5 months of 6cm × 5 cm. Ultrasound revealed a well-defined tubular cystic structure, measuring 5 cm × 3.5 cm × 5 cm with a volume of 50-60 ml. The cyst was dissected and the neck of the sac was extended up to the deep ring. Clear fluid was found on opening the sac. Clinically, it appears either as a painless or a moderately painful fluctuant inguinal mass. Clinical findings alone do not help in diagnosing the disease. Treatment includes surgical excision of the mass but without puncturing it as aspiration is inadequate and results in recurrence.
PubMed: 35813452
DOI: 10.1093/jscr/rjac316 -
Case Reports in Medicine 2022Sister Mary Joseph's nodule (SMJN) is a rare illness characterized by an umbilical mass caused by tumor metastases in the abdomen or pelvis. The most common main site of...
INTRODUCTION
Sister Mary Joseph's nodule (SMJN) is a rare illness characterized by an umbilical mass caused by tumor metastases in the abdomen or pelvis. The most common main site of SMJN in women is ovarian cancer. . A 73-year-old woman with no pathological history came to our emergency room with a one-month history of umbilicus enlargement. A 9-centimeter uncomfortable umbilical swelling with hard consistency was discovered during a clinical examination. An ovarian tumor with several local expansions was seen on an abdominal CT scan. It was linked to peritoneal metastases, one of which extends via a supraumbilical hernial orifice and into intestinal tissues in the same hernia sac. The umbilical tumor was removed from the patient. A moderately differentiated serous carcinoma with ovarian origin was identified in a periumbilical site on histological testing.
CONCLUSION
The presence of an SMJN is a rare but significant issue that clinicians must examine because it is associated with a bad prognosis. Early detection and diagnosis of the original lesion can lead to more effective treatment and a higher rate of survival.
PubMed: 35813004
DOI: 10.1155/2022/5131705 -
Medicine Jul 2022Abdominal cocoon or sclerosing encapsulating peritonitis is an uncommon condition in which the small bowel is completely or partially encased by a thick fibrotic...
BACKGROUND
Abdominal cocoon or sclerosing encapsulating peritonitis is an uncommon condition in which the small bowel is completely or partially encased by a thick fibrotic membrane. Our study presents a case of sclerosing encapsulating peritonitis and conducts a literature review.
METHODS
A bibliographic research was conducted. Our research comprised 97 articles. Gender, age, symptoms, diagnostic procedures, and treatment were all included in the database of patient characteristics.
CASE PRESENTATION
A 51-year-old man complaining of a 2-day history of minor diffuse abdominal pain, loss of appetite, and constipation was presented in emergency department. Physical examination was indicative of intestinal obstruction. Laboratory tests were normal. Diffuse intraperitoneal fluid and dilated small intestinal loops were discovered on computed tomography (CT). An exploratory laparotomy was recommended, in which the sac membrane was removed and adhesiolysis was performed. He was discharged on the tenth postoperative day.
RESULTS
There were 240 cases of abdominal cocoon syndrome in total. In terms of gender, 151 of 240 (62.9%) were male and 89 of 240 (37%) were female. Ages between 20 and 40 are most affected. Symptoms include abdominal pain and obstruction signs. For the diagnosis of abdominal cocoon syndrome, CT may be the gold standard imaging method. The surgical operation was the treatment of choice in the vast majority of cases (96.7%). Only 69 of 239 patients (28.9%) were detected prior to surgery, and CT was applied in these cases.
CONCLUSION
Abdominal cocoon is a rare condition marked by recurrent episodes of intestinal obstruction. Surgical therapy is the most effective treatment option.
Topics: Abdominal Pain; Adult; Female; Humans; Intestinal Obstruction; Intestine, Small; Male; Middle Aged; Peritoneal Fibrosis; Peritonitis; Young Adult
PubMed: 35801789
DOI: 10.1097/MD.0000000000029837