Intestinal malrotation is rare in older children and adults. We performed laparoscopic repair and treatment for a 13-year-old girl diagnosed as having intestinal malrotation complicated by midgut volvulus. Under laparoscopic vision, the midgut volvulus was untwisted by grasping and pulling the intestine; Ladd's band was divided and broadened; hepatic and splenic flexure of the colon was fixed; and finally an appendectomy was performed. The patient was walking and able to resume oral intake on the first postoperative day. There was no complaint in 6 months of follow-up, and the small incisional scar satisfied the patient and her parents.
Ciliated hepatic foregut cysts (CHFCs) are rare congenital cystic lesion that are most often solitary, unilocular, and located in the subcapsular region of the medial segment of the left hepatic lobe. The mucoid fluid contents affect imaging studies and often make definitive diagnosis difficult. CHFCs are usually asymptomatic and found incidentally. We report a 69-year-old female patient with a CHFC causing obstructive jaundice, which was difficult to differentiate from a biliary cystic neoplasm. A well-defined cystic lesion measuring 25 mm in diameter was located in the porta hepatis region. The lesion was densely adherent to the left and right hepatic ducts, riding on the bifurcation, and the common hepatic duct was extrinsically compressed. An extended left hepatectomy was performed. A diagnosis of CHFC was made on the basis of typical histological findings. CHFC should be included in the differential diagnosis for cystic lesions of the liver.
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