Highlights
Tubulo-villous adenoma is a rare benign appendiceal neoplasm.
This neoplasm is often asymptomatic and occasionally discovered at surgery.
Acute appendicitis is the most common clinical presentation.
Pre-operative diagnosis, even with the help of radiological imaging, is difficult.
Appendectomy is considered the correct treatment.
Introduction
Jejunogastric intussusception following gastric surgery is a rare complication that, if not diagnosed early, can have catastrophic outcomes.
Presentation of case
We have reported a case, never described previously, of an acute spontaneous retrograde JGI, presenting with obstruction and hematemesis, in a 70-year-old woman who has never, previously, undergone abdominal surgery.
Discussion
As in all cases of intestinal intussusception, early diagnosis is important for acute JGI as mortality rates increase from 10% when the intervention occurs within 48 h. to 50% if treatment is delayed for 96 h.
The diagnosis of JGI can be determined with many imaging studies, such as endoscopy, ultrasonography (US), barium stadium and CT scan.
Although JGI, up to now, has been described as a rare complication after any type of gastric surgery, this disease must, however, be suspected also in patients who have never undergone abdominal surgery, if they present with non-sedable abdominal pain associated with signs of high intestinal obstruction and hematemesis.
Conclusion
Our hope is to add to the available literature to aid physicians in their diagnostic work-up and in developing management plans for similar cases occurring in the future.
Highlights
Meckel’s diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract.
Annular MD is an extremely rare cause of intestinal obstruction and ischemia in adults.
Preoperative diagnosis of MD is a challenge because of its rarity and the absence of specific radiological findings and symptoms.
Surgery represents the appropriate treatment of complicated MD.
The inguinal hernia repair is one of the most frequent surgical procedures: in the world, even year, at least 20.000.000 inguinal hernia repair procedures are performed. Although the laparoscopic approach is widely recognized as a valid treatment for many diseases and some laparoscopic surgical procedures have become gold standard techniques (e. g. cholecystectomy, appendectomy, gastro-esophageal junction surgery), the minimally invasive approach for groin hernia treatment is still very controversial today, but in the last few years, it tends to become the standard practice for 1 day surgery. We present here the technique of laparoscopic Transabdominal Preperitoneal approach (TAPP). The surgical technique is described step-by-step, including surgical details and the new concept of “inverted Y” to achieve the “critical view of safety” for laparoscopic inguinal hernia repair.
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