Small bowel obstruction is a relatively common disease process accounting for up to 16 percent of surgical admissions and more than 300,000 operations annually in the United States. Approximately 5–8 percent of small bowel obstructions can be attributed to internal hernias. A slightly lower percentage, roughly 4–7 percent, of these internal hernias are noted to originate from a defect in the broad ligament of the uterus. A majority of broad ligaments defects causing a small bowel obstruction are not diagnosed preoperatively due to the equivocal imaging findings as well as the infrequency of this etiology. To date, there are very few case reports describing this disease process. This case report describes a 70-year-old female who was found to have a defect in her broad ligament causing a small bowel obstruction leading to subsequent strangulated bowel.
Adenoid cystic carcinoma (ACC), characterized by proliferating glands and stromal and basement membrane elements, is a tumor most commonly occurring in the salivary glands; very rarely does this tumor present as a primary tumor in the breast. We present the case of a 53-year-old female who presented with a breast mass noted to be concerning on imaging and confirmed to be ACC on biopsy. The mass was amenable to surgical excision with referrals to medical and radiation oncology. Due to the rarity of the disease, there is no consensus regarding the optimal treatment strategy for the pathology, including the use of chemotherapy and radiation. Long-term follow-up is, however, recommended in order to monitor for recurrence.
An adult intussusception is a relatively rare entity and is more commonly confined to the small bowel when it is found. The majority of the colonic intussusceptions in adults are caused by malignant neoplasms. Here we present the case of a 65-year-old female with a cecal adenoma as the lead point causing intussusception all the way to the splenic flexure. Controversy still exists regarding optimal treatment strategies, specifically the question of if it is safe or not to perform preoperative reduction prior to surgical resection in adult large bowel intussusceptions.
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