scholarly journals Gossypiboma with perforation of the umbilicus mimicking a complicated urachal cyst: a case report

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mustapha S. Kabba ◽  
Martha Y. Forde ◽  
Kevin S. Beckley ◽  
Bernadette Johnny ◽  
Ann-Marie B. M. Jah-Kabba ◽  
...  
Keyword(s):  
Unusual Case ◽  
Open Appendectomy ◽  
Exploratory Laparotomy ◽  
Urachal Cyst ◽  
History Of Surgery ◽  
Surgical Sponge ◽  
Case Presentation ◽  
Retained Surgical Sponge ◽  
Peripheral Hospital ◽  
History Of

Abstract Background A retained surgical sponge, also known as a gossypiboma, is a rare cause of serious postoperative complications. Diverse retained surgical materials including instruments such as clamps and sutures have been reported, but surgical sponges are the most common material. We report an unusual case of a gossypiboma mimicking a complicated urachal cyst that led to perforation of the umbilicus. Case presentation A 38-year-old female patient presented in our facility with a palpable periumbilical mass and discharge of pus from the umbilicus for 7 months after an open appendectomy. Since the onset of symptoms, the patient had been treated conservatively in a peripheral hospital where she had been operated on. As no improvement was seen, an ultrasound scan was performed that suggested an intraperitoneal abscess adjacent to the umbilicus. Consequently, the patient was referred to our specialist outpatient department for surgical intervention. Suspecting a complicated urachal cyst, an exploratory laparotomy was performed but revealed a retained surgical sponge as the underlying cause. The gossypiboma was resected, and the postoperative period was unremarkable. Conclusion This case demonstrates that gossypibomas, even though rare, continue to occur. They may clinically and radiologically mimic other pathologies, especially abscesses and tumors. Preventive measures as well as the inclusion of gossypibomas in the differential diagnosis of intraabdominal masses or fistulation detected in patients with a history of surgery are of utmost importance to minimize morbidity, mortality, and potential medicolegal implications.

563 A Rare Case of Small Bowel Obstruction Secondary to Peritoneal Encapsulation, Congenital Adhesional Band and Gallstone Ileus

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Gungadin ◽  
A Taib ◽  
M Ahmed ◽  
A Sultana
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Unusual Case ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Case Presentation ◽  
Peritoneal Encapsulation ◽  
History Of ◽  
Gall Stone Ileus

Abstract Introduction Small bowel obstruction can be caused by multiple factors. We describe an unusual case of small bowel obstruction secondary to three rare factors: gallstone ileus, peritoneal encapsulation and congenital adhesional band. Case Presentation A seventy-nine-year-old male presented with a four-day history of obstipation and abdominal pain. CT abdomen pelvis revealed small bowel obstruction secondary to gallstone ileus. The patient was managed by laparotomy. The intraoperative findings revealed the presence of a congenital peritoneal encapsulation with an adhesional band and gallstone proximal to the ileo-caecal valve. Although there was some dusky small bowel, this recovered following the release of the band. Discussion Peritoneal Encapsulation is a rare congenital pathology resulting in the formation of an accessory peritoneal membrane around the small bowel. This condition is asymptomatic and rarely presents as small bowel obstruction. The diagnosis is often made at laparotomy. There are less than 60 cases reported in literature. Gallstone ileus is another rare entity caused by an inflamed gallbladder adhering to part of the bowel resulting in a fistula. Conclusions The rarity of these conditions mean that they are poorly understood. A combination of this triad of gall stone ileus in the presence of peritoneal encapsulation and congenital band has not been reported before. Knowledge of this would raise awareness, facilitate diagnosis and management of patients.

scholarly journals Ascending aorta graft pseudoaneurysm and aortobronchial fistula caused by a fractured sternal wire: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ahmad Ali Amirghofran ◽  
Elahe Nirooei ◽  
Mohammad Ali Ostovan
Keyword(s):  
Unusual Case ◽  
Preventive Measures ◽  
Prosthetic Graft ◽  
Ascending Aorta ◽  
Dacron Graft ◽  
Thoracoabdominal Aorta ◽  
Case Presentation ◽  
Pseudoaneurysm Formation ◽  
Aortobronchial Fistula ◽  
History Of

Abstract Background Pseudoaneurysm of ascending aorta is a rare but serious complication of cardiovascular surgeries and it infrequently occurs in the normal prosthetic graft materials. We share our experience with an unusual case of ascending aorta Dacron graft pseudoaneurysm caused by a fractured sternal wire. Case presentation A 34-year-old man, known case of Marfan syndrome, with history of two prior aortic surgeries for aneurysm of ascending aorta, arch and thoracoabdominal aorta, presented with hemoptysis. The hemoptysis originated from an aortobronchial fistula secondary to a huge ascending aorta Dacron graft pseudoaneurysm. The graft erosion and subsequent pseudoaneurysm was caused by a fractured sternal wire. Surgical repair of the pseudoaneurysm was performed successfully and a Gore-tex patch was placed behind the sternum over the graft to prevent further direct contact of the wire and the graft. Conclusion Sternal wires can damage the adjacent vascular grafts and lead to fatal complications such as pseudoaneurysm formation. Thus, preventive measures such as using sternal bands and placing a covering layer between the sternal wires and aortic grafts are recommended in patients with dilated or replaced ascending aorta.

scholarly journals An unusual case of acute lower gastrointestinal bleeding due to fungal infection

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096782
Author(s):  
Jianchun Xiao ◽  
Ruopeng Zhang ◽  
Wanqi Chen ◽  
Beizhan Niu
Keyword(s):  
Gastrointestinal Bleeding ◽  
Fungal Infection ◽  
Lupus Erythematosus ◽  
Unusual Case ◽  
Exploratory Laparotomy ◽  
Lower Gastrointestinal Bleeding ◽  
Pathological Examination ◽  
Disorder Of Consciousness ◽  
Glucocorticoid Treatment ◽  
History Of

A 63-year-old woman was admitted to our hospital with herpes zoster viral infection and intermittent disorder of consciousness. On day 13 of hospitalization for glucocorticoid treatment, the patient experienced seven episodes of hematochezia. She had a 2-year history of systemic lupus erythematosus and had undergone splenectomy at 40 years of age. Computed tomography and electronic endoscopy revealed bleeding and contrast agent leakage into the splenic flexure of the colon. The patient underwent an emergency exploratory laparotomy and left hemicolectomy for suspected active hemorrhaging into the digestive tract. Pathological examination revealed that the bleeding had been caused by a fungal infection. No further hemorrhaging occurred after the surgery, suggesting that intestinal fungal infection might be a potential differential diagnosis for gastrointestinal bleeding in compromised hosts.

scholarly journals Unusual case of classic testicular seminoma in a 90-year-old patient: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Ahmad Al-Mousa ◽  
Mohammad Nour Shashaa ◽  
Mohamad Shadi Alkarrash ◽  
Mohamad Alkhamis ◽  
Lina Ghabreau ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Elderly Patients ◽  
Unusual Case ◽  
Medical Literature ◽  
Testicular Tumor ◽  
Testicular Seminoma ◽  
Case Presentation ◽  
History Of ◽  
Pure Seminoma

Abstract Background Seminoma is the most common subtype of testicular cancer and occurs most commonly in patients aged 30–49 years, but decreases to a very low level in men in their 60s or older. Case presentation A 90-year-old Syrian man with a 6-year history of an increase in size of his right scrotum, presented to the urological clinic and, on clinical examination, the findings suggested testicular tumor. After orchiectomy and histology results based on microscopic and immunohistochemical examinations, a pure seminoma was diagnosed, so we describe in this case report the second-oldest patient with classical seminoma in the medical literature. Conclusion This case report has been written to focus on the probability of any type of testicular tumor occurring at any age or decade; urologists should consider seminoma as a differential diagnosis with any testicular swelling even in elderly patients.

scholarly journals Retained Intraabdominal Gossypiboma, Five Years after Bilateral Orchiopexy

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammad Kazem Moslemi ◽  
Mehdi Abedinzadeh
Keyword(s):  
Medical Training ◽  
Final Diagnosis ◽  
The Body ◽  
Surgical Sponge ◽  
Human Errors ◽  
Strict Adherence ◽  
Case Presentation ◽  
Radiologic Evaluation ◽  
Surgical History ◽  
History Of

Introduction.Gossypiboma or textiloma is used to describe a retained surgical swab in the body after an operation. Intraabdominal surgical sponge is an uncommon surgical error. The incidence of gossypiboma has been reported as high as 1 in 1000 to 15,000 intraabdominal operations. Gossypiboma may cause serious morbidity and may lead to mortality.Case presentation.Herein, we report a 24 years-old man who was admitted due to the intraabdominal mass after evaluation of primary infertility. He had a surgical history of bilateral abdominal orchiopexy 5 years previously, performed at another hospital. Hydatid cyst was suspected by abdominal computed tomography. After laparotomy excision, the cyst wall opened incidentally, and draining of a large amount of thick pus with retained surgical gauze within the cyst was found, with final diagnosis of gossypiboma.Conclusion.The policy that prevention is far more important than cure is highly appreciated. Accurate sponge and instrument counts, along with radiologic evaluation when a discrepancy is found, can be helpful. Although human errors cannot be completely avoided, continuous medical training and strict adherence to rules of the operation room should reduce the incidence of gossypiboma to a minimum. Surgical sponges should be counted once at the start and twice at the end of all surgical operations.

scholarly journals An Unusual Case of Asystole Occurring during Deep Brain Stimulation Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Ha Son Nguyen ◽  
Harvey Woehlck ◽  
Peter Pahapill
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Unusual Case ◽  
Case Presentation ◽  
Volume State ◽  
Lead Placement ◽  
History Of ◽  
Symptomatic Bradycardia ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

Background. Symptomatic bradycardia and hypotension in neurosurgery can produce severe consequences if not managed appropriately. The literature is scarce regarding its occurrence during deep brain stimulation (DBS) surgery.Case Presentation. A 67-year-old female presented for left DBS lead placement for essential tremors. During lead implantation, heart rate and blood pressure dropped rapidly; the patient became unresponsive and asystolic. Chest compressions were initiated and epinephrine was given. Within 30 seconds, the patient became hemodynamically stable and conscious. A head CT demonstrated no acute findings. After deliberation, a decision was made to complete the procedure. Assuming the etiology of the episode was the Bezold-Jarisch reflex (BJR), appropriate accommodations were made. The procedure was completed uneventfully.Conclusion. The episode was consistent with a manifestation of the BJR. The patient had a history of neurocardiogenic syncope and a relatively low-volume state, factors prone to the BJR. Overall, lead implantation can still occur safely if preventive measures are employed.

scholarly journals Phytobezoar causing intestinal obstruction in a neonate: A case report

2020 ◽  
Vol 10 ◽  
pp. 3
Author(s):  
Ravi Patcharu ◽  
Karunesh Chand ◽  
Badal Parikh
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Skill ◽  
Exploratory Laparotomy ◽  
History Taking ◽  
Case Presentation ◽  
Detailed History ◽  
Radiological Features ◽  
Common Etiology ◽  
History Of ◽  
Vegetative Matter

Background: Phytobezoars are concretions of non-digestible vegetative matter in the gastroin­testinal tract and are a rare cause of intestinal obstruction in children. Case presentation: We report a case of intestinal obstruction in a 2-day-old neonate with no specific radiological features pointing to any common etiology. On exploratory laparotomy, a swollen raisin was found impacted in the ileum causing intestinal obstruction. The history taken in retrospect revealed that the elder sibling had witnessed her father perform a traditional ritual of putting a drop of honey into the mouth of the newborn and she imitated the same with a raisin, which led to the obstruction. Conclusion: A careful detailed history of local traditional rituals is at times, the most important pointer towards the etiology of a clinical condition. The basic clinical skill of history taking is still very important, despite the availability of advanced radiological investigations.

Gossypiboma - A Diagnostic Dilemma

2021 ◽  
Vol 11 (5) ◽  
pp. 329-332
Author(s):  
Faaizah Shaikh ◽  
Sujoy Mani ◽  
Abhay Gursale
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Exploratory Laparotomy ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Surgical Sponge ◽  
Retained Foreign Body ◽  
History Of ◽  
Gastric Mass ◽  
Vague Abdominal Pain

A surgical sponge is the most common type of retained foreign body (RFB) also known as a gossypiboma (gossypium = cotton, boma = concealment). It is mostly asymptomatic but can lead to a host of symptoms in the patient ranging from pain in the abdomen to anorexia and weight loss. It poses a diagnostic challenge not just for the surgeon but also the radiologist as it can mimic an intraabdominal mass. Here we present a case of a 58 yrs old male who presented with dysphagia and abdominal pain on and off who was radiologically diagnosed as a case of gastric mass and subsequently underwent exploratory laparotomy where it was proven to be a gossypiboma. The case attempts to highlight the importance of keeping gossypiboma as a differential diagnosis for patients with vague abdominal pain and history of a surgery in the past. Key words: gossypiboma, sponge, abdominal pain, computed tomography, foreign body.

scholarly journals Corneal Epithelial Hyperplasia after 5-Fluorouracil Injection

2018 ◽  
Vol 9 (1) ◽  
pp. 254-256 ◽  
Author(s):  
Dania A. Bukhari ◽  
Sarah K. Alessa ◽  
Safaa I. Beheiri
Keyword(s):  
Rna Synthesis ◽  
Unusual Case ◽  
Epithelial Hyperplasia ◽  
Progressive Decrease ◽  
Case Presentation ◽  
Corneal Epithelial ◽  
Corneal Scarring ◽  
Lens Implantation ◽  
Pyrimidine Analogue ◽  
History Of

Background: 5-Fluorouracil (5-FU) is a pyrimidine analogue which selectively inhibits DNA synthesis, RNA synthesis, and VEGF antibodies. 5-FU is widely used in ophthalmology for inhibition of postoperative corneal scarring and scleral bleb fibrosis. Case Presentation: In this case report, we describe an unusual case of a 65-year-old male who presented to the clinic with progressive decrease of vision after he underwent a revision of scleral bleb with the administration of 0.05 mL 5-FU (2.5 mg) injection and was diagnosed with corneal epithelial hyperplasia. The patient had a history of glaucoma managed by deep sclerotomy and phacoemulsification with intraocular lens implantation. Conclusion: Our case demonstrates an unusual consequence of corneal epithelial hyperplasia developed after 5-FU injection.

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