RESUMEN
Endometriosis is the abnormal existence of functional uterine mucosal tissue outside the uterus. It is a usual disorder of women in reproductive age which is mainly located in the female genital tract. Hepatic endometriosis is one of the rarest disorders characterized by the presence of ectopic endometrium in the liver. It is often described as cystic mass with or without solid component. Preoperative diagnosis is difficult via cross-sectional imaging and histopathologic evaluation remains the gold standard for diagnosis. We report an asymptomatic 40-year-old female with a large cystic mass involving the left hepatic lobe. She underwent laparoscopic removal of the cyst. The diagnosis of hepatic endometriosis was established by the histopathological analysis of the surgical specimen.
Asunto(s)
Endometriosis/diagnóstico , Hallazgos Incidentales , Hepatopatías/diagnóstico , Adulto , Biopsia , Diagnóstico Diferencial , Endometriosis/diagnóstico por imagen , Endometriosis/patología , Endometriosis/cirugía , Femenino , Humanos , Laparoscopía , Hepatopatías/diagnóstico por imagen , Hepatopatías/patología , Hepatopatías/cirugía , Imagen por Resonancia Magnética , Valor Predictivo de las Pruebas , Resultado del TratamientoRESUMEN
Gallstone ileus is a rare but potentially serious complication of cholelithiasis. It is usually preceded by history of biliary symptoms. It usually occurs as a result of a large gallstone creating and passing through a cholecysto-enteric fistula. Most of the time, the stone will pass the GI tract without any problems, but large enough stones can cause obstruction. The two most common locations of impaction are the terminal ileum and the ileocaecal valve because of the anatomical small diameter and less active peristalsis. We present an unusual case of small bowel obstruction secondary to gallstone ileus 24 years after an open cholecystectomy.
Asunto(s)
Colecistectomía , Colelitiasis/complicaciones , Cálculos Biliares/complicaciones , Ileus/etiología , Anciano , Colelitiasis/diagnóstico por imagen , Colelitiasis/etiología , Colelitiasis/cirugía , Cálculos Biliares/diagnóstico por imagen , Cálculos Biliares/cirugía , Humanos , Ileus/diagnóstico por imagen , Ileus/cirugía , Masculino , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
Spontaneous rupture of a non parasitic hepatic cyst is an extremely rare occurrence. A 50 -year- old male, was admitted with typical clinical manifestations of acute surgical abdomen. At exploratory laparotomy, a giant ruptured non parasitic cyst occupying the entire left liver lobe was found, along with a large amount of free intraperitoneal fluid. The cyst was widely unroofed very close to the liver parenchyma. The patient had an uneventful postoperative course and was discharged six days later. The clinical presentation, diagnostic evaluation and surgical management of this extremely rare clinical entity are discussed, along with a review of the literature. This case, which according to our best knowledge is the fourth reported in the literature, highlights the considerable risk of serious complications associated with the presence of a large symptomatic nonparasitic hepatic cyst. Prophylactic treatment should be considered in all these cases.