Background: Retrorectal cyst are rare lesions. Their clinical presentation is nonspecific, thus hampering their detection and frequently leading to misdiagnosis. According to their origin and histopathologic features, rectorectal cysts are classified as epidermoid, dermoid, enteric (tailgut cysts and cystic rectal duplication), and neurenteric cysts. Here we present the clinical, radiological and surgical findings in a case with a retrorectal dermoid cyst. Case Report: A 47-year-old male patient presented with rectal fullness and pain. MRI and CT studies revealed a noncalcified, unilocular, cystic mass lesion with well-defined borders. On MRI, self-contained fat spheres were detected inside the cyst. The cyst was excised completely by laparotomy. Pathological assessment revealed a dermoid cyst. The patient’s postoperative period was uneventful, and there was no recurrence during a 2-year follow-up. Conclusion: Complete surgical excision is indicated to establish the diagnosis and avoid complications of retrorectal cysts.
Background: Situs inversus totalis (SIT) is a rare condition with an autosomal recessive genetic predisposition. In abdominal surgery this condition can be associated with substantial difficulties. Here we report diagnostic pitfalls and technical details of two patients with SIT and bile stone diseases who were treated by endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and laparoscopic cholecystectomy (LC). Patients and Methods: The patients were evaluated according to age, symptom as well as radiological, ERCP and surgical findings. Results: One of the patient is 41-yearold woman with known SIT having previous laparoscopy for infertility. Her abdominal ultrasound showed microlithiasis in the left sided gallbladder, and laboratory findings were within normal limits. The second patient was 37-year-old man with signs and symptoms of cholangitis. He had an icterus. Abdominal ultrasound, magnetic resonance cholangiopancreatography and ERCP investigations showed microlithiasis in the gallbladder and also a dilatation of the biliary ducts. Sphincterotomy and extraction of the stones were done. In both patients LC was successfully performed. Conclusion: Although it is time-consuming and difficult to demonstrate mirror image anatomy, minimal invasive treatment by ERCP, sphincterotomy and LC can be safely and effectively applied in patients with SIT suffering from bile stone disease, and iatrogenic injuries can be reliably prevented.
Gastrointestinal stromal tumors (GISTs) are a rare type of nonepithelial mesenchymal neoplasms of the gastrointestinal tract belonging to a heterogeneous group of diseases that differ in frequency, clinical symptoms and pathologic behavior. Case Report: A 62-yearold man was admitted to our hospital with hematemesis and melena. The patient had undergone a distal gastrectomy for peptic ulcer 28 years ago. Gastroscopy revealed a huge polypoid tumor occupying the remnant stomach. Contrast-enhanced CT of the abdomen revealed a huge (6.5 × 4 cm in size), irregularly enhanced tumor extending from the cardia to the corpus and projecting in to the lumen of the stomach. GIST was proven by endoscopic biopsy.The patient underwent total resection of the remnant stomach. Histopathology revealed a highly malignant GIST of the stomach. The patient’s postoperative period was uneventful, and there was no recurrence or distant metastasis during a 12-month follow-up. Conclusion: GISTs may arise virtually in any part of the gastrointestinal tract. Even patients who had undergone distal gastrectomy are at risk for the development of GISTs.
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