RESUMEN

INTRODUCTION: A left paraduodenal hernia is a rare congenital malrotational anomaly of the midgut that occurs in the paraduodenal fossa of Landzert to the left of the fourth duodenum. It is responsible for approximately 1% of small bowel obstructions. CASE PRESENTATION: We report a case of left paraduodenal hernia combined with small bowel obstruction in a 47-year-old Mediterranean woman who had a history of recurrent abdominal pain. An abdominal computed tomography scan showed a saclike mass clustered in the left upper quadrant but failed to yield a clear diagnosis. We describe the surgical anatomy of this disease and the emergency surgical management together with a short review of the literature. CONCLUSIONS: Even though a left paraduodenal hernia is rare, it must be suspected in any upper intestinal occlusion. The high morbidity and mortality rate of complicated cases should motivate preventive treatment in case of incidental operative discovery.

RESUMEN

CONTEXT: Pancreatic tumors in the midportion have traditionally been treated by an extended right or left pancreatectomy. A medial or central pancreatectomy is an alternative technique for benign or low-grade malignant neoplasms located to the left of the gastroduodenal artery and close to the splenomesenteric confluence. CASE REPORT: A 38-year-old woman with no previous surgical history presented with epigastric abdominal pain. A computed tomography scan showed a 4 cm heterogeneous lesion within the pancreatic body. This tumor invaded the splenic artery and vein. There was no postoperative diabetes mellitus or exocrine insufficiency. The patient continues to be well after a 10-month follow-up without pancreatic insufficiency or local recurrence, and CT has demonstrated splenic perfusion by the collateral vessels. CONCLUSION: We believe that a medial or central pancreatectomy may be a safe procedure where there is involvement of the large splenic vessels by a low grade malignant pancreatic tumor and that a systematic splenectomy is not justified.

Asunto(s)

RESUMEN

Paragangliomas are extra-adrenal chromaffin tumours that develop at the expense of neuroectodermal cells of the autonomous nervous system. Retroperitoneal and nonfunctioning forms are very rare. They are often asymptomatic and can reach a substantial size. Treatment usually involves surgery with the goal of total excision. We report the case of a patient who presented with indistinct abdominal pain. This case demonstrates how the diagnosis of retroperitoneal nonfunctioning paragangliomas relies mostly on histological results.

Asunto(s)

RESUMEN

Retroperitoneal contamination may occur during the natural history of hydatid disease. Primary hydatid cyst of the retroperitoneum is extremely rare. The authors report a case of a giant retroperitoneal hydatid cyst. Clinicians and surgeons must be aware of this possibility and follow a policy of nonsystematic puncture of an abdominal cyst and avoid spillage during surgery. Symptoms are related to the size, location, or ensuing complications of a cyst. Its occurrence should be strongly suspected ahead of any abdominal cyst, especially in an endemic area, where it may act as a parasite. Total and careful surgical excision is the gold-standard therapy.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

A primary hemangiopericytoma (HP) of the bone is rare, because the vast majority of these tumors arise in soft tissue. This report presents a case of a hemangiopericytoma in the sacrum (S1-S2) with extension to the retrorectal space. Only a few cases of osseous hemangiopericytomas in the sacrum and involving the retrorectal space have so far been reported. The difficult diagnosis of HP and the surgical strategy was chosen according to the location of the lesion in the sacrum and retrorectal space. A local excision was indicated. A sacral resection should be considered for tumors below S4. This report demonstrated the safety of this strategy. Adjuvant radiotherapy is useful in HP. The value of chemotherapy is still doubtful, although patients with high-grade tumors or metastatic spread seem to gain substantial benefit. Due to the often unpredictable behavior of this neoplasm, extended follow-up is strongly recommended.

Asunto(s)

RESUMEN

We describe herein the case of a 45-year-old man who developed an osteochondroma from the xyphoid appendix into an abdominal wall scar from a laparotomy performed 4 years previously. To our knowledge, rare cases of osteochondroma of the xyphoid bone have been documented in the literature. As shown by the tumor's rapid development during a period of only 4 years, osteochondromas arise from, or grow well under, inflammatory and cicatricial conditions. Periosteal contusion causing growth-plate cartilage migration and enchondral ossification seems to be the first presentation of osteochondroma.

Asunto(s)

Asunto(s)