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At least 379 records · Page 21Linked to original sources
PubMed1997

Disseminated intra-abdominal cystic lymphangiomatosis with severe intestinal bleeding. A case report.

We describe cystic lymphangiomatosis with intestinal bleeding developing multiple lymphangiomas in the small intestine, mesentery, mesocolon, omentum, retroperitoneum, and spleen. Small intestinal fluorography showed multiple polypoid lesions, mainly in the jejunum. Ultrasonography, computed tomography, and magnetic resonance imaging showed diffuse cystic tumors in the mesentery and spleen. Cystic lymphangiomatosis was proved by histologic findings of the biopsied specimen at laparotomy.

Abdominal Neoplasms↗
PubMed1996

Missed injuries in abdominal trauma.

Injuries missed at initial diagnoses or operations have the potential to cause disastrous complications in abdominal trauma patients. The aim of this retrospective study is to assess the causes and the outcomes of missed abdominal injuries. Twelve patients (2%) with missed injuries were identified among 607 abdominal trauma patients operated on from 1985 to 1993. Ten patients were male and two were female. The modes of the trauma were ten blunt injuries (83%) and two stab penetrating injuries (17%). Five cases had delayed operations because of clinical errors in the initial diagnosis. Their causative factors were obscured trauma history (two cases), radiologic misinterpretation (two cases), no reliable radiologic finding (one case), and admission to inappropriate department (one case). Missed injured organs were spleen (two cases), liver (one case), diaphragm (one case), and rectum (one case). Median delayed time was 7 days (3 to 96 days). Another seven cases of injuries were missed at the time of initial operation because of incomplete exploration. Their causative factors were surgical inexperience (two cases), severe peritoneal adhesions (one case), neglected exploration of retroperitoneal hematoma (two cases), underestimated mesocolic vascular injury (one case), and early contraction of the perforating wound with intraoperative hypotension (one case). Missed injured organs were stomach (two cases), duodenum (one case), rectum (one case), pancreas (one case), urinary bladder (one case), and rectosigmoid mesocolon (one case). Median time interval between initial and second operation was 9 days (4 to 32 days). Two patients died of complications directly related to their missed injuries. Major complication and mortality rates of missed injuries were 83 and 17%, respectively. These were significantly higher compared with those (39 and 6.3%, respectively) of detected abdominal injuries. We conclude that missed abdominal injuries can cause high mortality and morbidity, and, therefore, a systematic approach, including careful history taking, complete diagnostic procedure, complete surgical explorations, and early reoperation are mandatory for patients with multiple trauma.

Abdominal Injuries↗
PubMed1977

Multiple leiomyosarcomas.

A 32-year-old woman underwent a conservative total excision of a leiomyosarcoma of the sigmoid mesocolon. During the subsequent six years she developed additional malignant and benign smooth muscle neoplasms in the soft tissues and uterus which were treated only by nonmutilating surgical excisions with an excellent result. Since we know of no proof to the contrary, we submit this case as an example for surgically excising adult soft tissue sarcomas in as conservative a manner as is sufficient to locally eradicate the disease. Adjunctive radiation or chemotherapy or both may prove to be beneficial.

Adult↗
PubMed1979

Intussusception after jejunoileal bypass.

We have described a case of intussusception of the defunctionalized loop of small bowel after jejunoileal bypass. This complication may be avoidable by suturing the free end of the proximal jejunum to the root of the transverse mesocolon. Diagnosis is aided by closely placing silver clips on these same structures and observing for their separation on radiographs of the abdomen.

Adult↗
PubMed1992

Transmesosigmoid hernia during pregnancy.

We have presented a case of internal herniation of small bowel through the sigmoid mesocolon in a pregnant woman. In patients with symptoms suggestive of bowel obstruction, even without a history of previous abdominal surgery, internal hernia must be included in the differential diagnosis.

Adult↗
PubMed1998

Coeliac disease presenting with intraperitoneal haemorrhage.

A 42-year-old man, who was previously fit and well, presented in haemorrhagic shock due to a spontaneous left mesocolonic haematoma and intraperitoneal bleed. His INR was noted to be raised on admission. Later investigations showed him to have villous atrophy on biopsy of the second part of his duodenum and a positive anti-reticulin antibody. His duodenal biopsy and INR normalized on a gluten-free diet. Coeliac disease may present with a single vitamin deficiency with potentially catastrophic results.

Adult↗
PubMed1988

A case of multiple extra-adrenal pheochromocytomas.

A case report of a 37-year-old previously healthy man who contracted hypertension and insulin-dependent diabetes mellitus. Urinary catecholamine excretion was elevated. A total of nine benign pheochromocytomas with characteristic histological appearance were successfully removed. Most of the tumors were located extra-adrenally in the upper abdomen and in the pelvis. Two of the tumors were found in organ plexuses in the mesocolon sigmoideum and in the anterior wall of prostata. Because of asynchronous tumor growth a life-long follow-up is recommended.

Abdominal Neoplasms↗
PubMed2005

Outcome of hepatic artery reconstruction in liver transplantation with an iliac arterial interposition graft.

BACKGROUND: In case of anomal hepatic arterial inflow, it can be necessary to perform revascularization of the liver allograft by iliac arterial interposition graft. METHODS: We analyzed retrospectively 613 liver transplants in a 16-yr period. The hepatic artery (HA) graft group (n = 101) consisted of patients with arterial inflow based on recipient infrarenal aorta using donor iliac artery graft tunneled through the transverse mesocolon. The control group (n = 512) consisted of patients who underwent liver transplantation with routine HA reconstruction. RESULTS: Both groups are homogeneous and comparable. In case of retransplantation, arterial conduit with iliac graft was adopted more frequently instead of conventional arterial anastomosis (24.8% vs. 9%, p < 0.0001). The 1-, 3- and 5-yr overall survival was 85.41, 79.42, 76.57% in the control group and 76.21, 73.43, 73.43% in the HA graft group, respectively (p = ns). The 1-, 3- and 5-yr graft survival was better in the control group (81.51, 73.66, 69.22% vs. 71.17, 62.50, 53.42%) (p = 0.01). In case of retransplantation, the 1-, 3- and 5-yr overall (57.81, 53.95, 41.96% vs. 60, 51.95, 49.85%) and graft survival (57.52, 53.68, 41.75% vs. 56, 50.4, 40.3%) was similar in control and HA graft group, respectively (p = ns). Hepatic artery thrombosis (HAT) rate is 21.8% vs. 8.6% (p < 0.0001) in HA graft group and control group, respectively. The only factor independently predictive of early HAT resulted arterial conduit (p = 0.001, OR = 3.13, 95% CI: 1.57-6.21). Retransplant procedure, donor age and arterial iliac conduit were found to be a significant risk factors for late HAT, at univariate analysis. At multivariate analysis, donor age >50 yr old resulted the only factor independently associated with late HAT (p < 0.0001, OR = 1.05, 95% CI: 1.02-1.07). CONCLUSION: Iliac arterial interpositional graft is an alternative solution for arterial revascularization of liver allograft in case of retransplantation when the use of HA is not possible. In case of primary transplantation, is better not to perform arterial conduit if it is possible, for poor graft survival and high incidence of early HAT, especially in case of liver donor aged over 50 yr.

Adult↗
PubMed2005

Peritoneal folds of the rabbit (Oryctolagus cuniculus).

The anatomy of the rabbit is not well known and there is no consensus on the anatomical nomenclature for this species. The objective of this study was to give a complementary description of the peritoneal folds in order to improve the existing knowledge on this species. Eighteen adult rabbits were studied. Ten animals were dissected unfixed and the remaining eight after fixation in formalin. The hepatic ligaments were similar to those of the dog. The transverse mesocolon was absent. The entry to the caudal recess of the omental sac was relatively smaller than that in other domestic species. We consistently found an omental foramen. An amount of fat tissue was almost always found in the proximal mesorchium. The vaginal process was inconstant.

Animals↗
PubMed1996

Postmenopausal intra-abdominal desmoplastic small cell tumor.

Intra-abdominal desmoplastic small cell tumor (DSCT) usually occurs in infants and young male adults. A case of DSCT occurring in a 60 year old female is described. No other apparent primary origin was detected. A mesocolon tumor, measuring 23 x 12 x 10 cm, was composed predominantly of round to spindle cells which showed epithelioid- and focally sarcomatous arrangements. Immunohistochemically, the tumor cells showed perinuclear dot-like staining of CAM5.2, many cells expressed HHF35, and some cells contained vimentin, epithelial membrane antigen, desmin, alpha-smooth muscle actin, neuron-specific enolase, or Leu 7. Electron microscopic examination showed that the tumor cells had mesenchymal-fibroblastic features. The tumor had an aneuploid DNA content with high S-phase fraction. The patient, who was treated with adjuvant chemotherapy, was alive, having had three recurrences in 36 months. In the second and third recurrent lesions, increased cellular atypia and fascicular arrangements of spindle cells were observed. DSCT should be included in differential diagnoses of post-menopausal pelvic tumors which show light-microscopically and immunohistochemically divergent phenotypes.

Abdominal Neoplasms↗
PubMed1997

Three approaches for laparoscopic unroofing of simple and complicated renal cysts.

We report 2 cases of simple renal cysts which were marsupialized with 2 laparoscopic approaches involving either transperitoneal, with reflection of the colon medially or dissection through the mesocolon, and a case of a multilocular renal cyst which was treated by the retroperitoneal approach. Although laparoscopic unroofing of a renal cyst is a safe and effective alternative to open surgical techniques, the transperitoneal approach should only be used for simple renal cysts. The retroperitoneal approach for complicated renal cysts may be indicated if preoperative examinations exclude the possibility of malignancy.

Aged↗
PubMed1978

Ruptured choledochal cyst: recognition and management.

A case is described of the rupture of a choledochal cyst in a 21-year-old man involved in a motor vehicle accident. At laparotomy, a haemoperitoneum was traced to a large haematoma in the lesser omentum which extended into the mesocolon and was found to be tinged with bile. Eventually it became apparent that the primary pathological condition was a large choledochal cyst into which opened the gallbladder. This cyst had split longitudinally down its anterior surface from the porta hepatis to the duodenum. Bile leakage was controlled by inserting a Foley catheter into the common hepatic duct, and inflating the balloon. Postoperative cholangiography showed massive cystic dilation of the intrahepatic ducts. Five days after the initial operation, a Roux-en Y cystjejunostomy was performed, and the patient has been well since. Crucial points in the emergency management of this condition appear to be in its recognition, and the provision of an adequate method of primary biliary drainage, if the condition of the patient demands staged management. End-to-end cystjejunostomy provides a satisfactory method of final drainage.

Accidents, Traffic↗
PubMed1992

Intestinal obstruction due to axial twisting of bowel in transmesenteric hernia.

A baby, born with gastroschisis, had an unrepaired large aperture in the mesocolon close to a short segment of colon. One day, the entire length of bowel proximal to the defect traversed the rent. The free segment of colon was affected by the resulting twist along the long axis of the bowel and became obstructed. A large mesenteric defect, albeit too wide to strangulate the bowel, is not totally innocuous and should always be closed.

Hernia, Ventral↗
PubMed1995

Laparoscopic left adrenalectomy: a new approach.

Left adrenalectomy has been performed previously via anterior, posterior, loin or thoracoabdominal approaches. In the classical transabdominal approach the left adrenal gland is resected following either mobilization of the spleen with the tail of the pancreas or after entering the lesser sac, mobilizing the inferior border of the pancreas off the adrenal gland. This report describes laparoscopic left adrenalectomy, in a patient with Conn's syndrome, performed by a new approach via the root of the left transverse mesocolon.

Adrenalectomy↗
PubMedDate not supplied

Laparoscopic cryptorchid castration in standing horses.

OBJECTIVE: This article describes a new technique for laparoscopic cryptorchid castration in standing horses. STUDY DESIGN: Prospective study. ANIMALS OR SAMPLE POPULATION: Eight horses aged 11 months to 3 years and weighing between 300 and 643 kg. METHODS: Food was withheld for 24 to 36 hours, and then horses were sedated with detomidine HCl (0.02 to 0.03 mg/kg) and butorphanol tartrate (0.02 mg/kg). The paralumbar fossa region was desensitized with 2% mepivacaine in an inverted "L" pattern and caudal epidural anesthesia was administered with either xylazine (0.18 mg/kg diluted to 10 to 15 mL with 0.9% sodium chloride) or a combination of 2% mepivacaine and xylazine (0.18 mg/kg). Initial laparoscopic exploration was performed from the left flank; in three horses, right flank laparoscopy was needed to complete the procedure. The spermatic cord was ligated within the abdomen with one or two sutures of 0 polydioxanone suture, and the testis or testes removed through a flank incision. RESULTS: In five horses with no palpably descended testes, standing laparoscopy was the only procedure performed, whereas in two horses, the abdominal testis was removed laparoscopically, and the descended testis was removed under short acting anesthesia. In one horse, with nonpalpable testes, it was determined by laparoscopic observation that the testes were in the inguinal canal, and castration was performed under general anesthesia. No surgical or postoperative complications were noted. The right side of the abdomen, and especially the right vaginal ring, could be easily observed from the left side by passing the laparoscope through a small perforation in the mesocolon of the descending colon or by elevating the descending colon with an instrument or by use of an arm in the rectum. CONCLUSIONS: The standing laparoscopic approach combined with or without short-acting anesthesia to remove the descended testis is easily performed. CLINICAL RELEVANCE: This approach will provide surgeons with another option to castrate cryptorchid stallions.

Anesthesia, General↗
PubMedDate not supplied

A modified technique for extensive large colon resection and anastomosis in horses.

OBJECTIVE: To describe an alternative technique for large colon resection and anastomosis in horses. STUDY DESIGN: Retrospective study of clinical patients. ANIMAL POPULATION: 37 horses that had ventral midline celiotomies between July 1, 1990, and July 1, 1994. METHODS: Large colon resection and anastomosis was performed using a modification of previously described techniques. Modifications include mesocolon ligation with a stapling device and an end-to-end apposition of the right ventral and right dorsal colon. RESULTS: Twenty-one of the 37 horses were discharged from the hospital without complications. Two horses were euthanatized immediately after recovery from anesthesia because of hindlimb fracture. Fourteen horses were euthanatized in the initial postoperative period because of persistent endotoxemia and abdominal pain. CONCLUSIONS: The described technique is a safe, reliable method for large colon resection and anastomosis in horses. CLINICAL RELEVANCE: The described technique is fairly simple to perform and requires less surgical time compared with other techniques.

Anastomosis, Surgical↗
PubMed2006

Torsion and volvulus of the transverse and descending colon in a German shepherd dog.

A German shepherd dog was presented two months after surgery for correction of acute gastric dilatation volvulus. The dog had been diagnosed with exocrine pancreatic insufficiency. Radiographs revealed marked gaseous distension of one loop of intestine with a generalised increase in intestinal gas content. A 360 degrees anticlockwise rotation of the descending and transverse colon, around the longitudinal axis of the mesocolon, was diagnosed at exploratory coeliotomy. The transverse and descending colon appeared uniformly necrotic and an end-to-end colo-colic resection and anastomosis was performed. The dog initially made satisfactory postoperative progress but was euthanased on the third postoperative day after it developed an intestinal intussusception.

Anastomosis, Surgical↗
PubMed1976

Mechanosensitive afferent units in the hypogastric nerve of the cat.

1. Recordings have been made from ninety single afferent units in the hypogastric and lumbar splanchnic nerves of the cat. 2. The majority of units examined had properties similar to those previously described in the splanchnic nerve: they were slowly adapting mechanoreceptors with one to six punctate mechanosensitive sites distributed mainly along blood vessels as they approached the viscera in peritoneal ligaments; they had a wide range of mechanical thresholds and conduction velocities in the range 0.5-24 m s-1. 3. Receptive fields were found over the bladder base or its peritoneal ligaments or both, on the uterus or broad ligament or both, on the colon or mesocolon or both, and in association with the ureter, vas deferens, prostate or pelvic fat pads. 4. Discharges from afferent units associated with the bladder were investigated during spontaneous (or reflex) bladder contractions, passive distensions, and tetanic contractions induced by electrical stimulation of the sacral spinal cord. The mean spike rates of the adapted (tonic) discharges, observed during distensions and induced tetani, differed over part of the range of intravesical pressures examined. Their behaviour is discussed in relation to the concept of 'in series' tension receptors within the bladder wall.

Action Potentials↗