Solitary or multiple lipomas are considered common tumors that can occur anywhere in the body; however, mesenteric lipoma is a rare entity that is well known to present with signs and symptoms of small bowel volvulus. Hereby, we present a case of a 54-year-old male patient with multiple comorbidities who was suffering from chronic abdominal discomfort and gradual increase of his abdominal distention over many years without seeking any medical attention. The patient was seen by a general practitioner after complaining of an inflated abdomen, as he described his condition. After several imaging studies, he was diagnosed with one of the largest mesenteric lipomas in the literature. Mesenteric lipoma should be present in the differential diagnosis of any abdominal tumor. Magnetic resonance imaging plays a major role in differentiating benign from malignant lipomas.
Patient: Female, 57-year-oldFinal Diagnosis: Gallbladder volvulusSymptoms: Abdominal and/or epigastric painMedication: —Clinical Procedure: Laparoscopic cholecystectomySpecialty: SurgeryObjective:Rare diseaseBackground:Gallbladder torsion is a rare entity of acute abdomen that can be fatal if not diagnosed and treated promptly. It presents in a multitude of ways but the most common is a presentation similar to acute cholecystitis. Diagnosis can be made clinically by abdominal ultrasound with Doppler flow, and treatment is detorsion with cholecystectomy.Case Report:A 57-year-old female presented to the emergency department with severe abdominal pain, bilious vomiting, and loose stools. An initial diagnosis of gastroenteritis was made, however, the patient did not respond to symptomatic treatment and continued having pain, nausea and vomiting. Abdominal ultrasound revealed signs of acute cholecystitis and the patient underwent an open cholecystectomy where the gallbladder was found to be black, gangrenous, and voluminous due to torsion. Detorsion and cholecystectomy were performed without any complications.Conclusions:Gallbladder torsion is a rare entity of acute abdomen that can be fatal if not diagnosed and treated promptly. Gallbladder torsion should be a part of the differential diagnosis of any patient presenting with an acute abdomen and unusual symptoms of acute cholecystitis.
Highlights Adenomyoepithelioma is a rare tumor of the breast characterized by a biphasic proliferation. Variable spectrum of behavior ranging from benign to malignant, with tendency to local recurrence. Combine sentinel lymph node dissection (SLND), with simple mastectomy. Hematogenous spread is the more common means of spread. Adjuvant chemotherapy for malignant AME cases is recommended.
Background: Intravenous drug abuse is an anciently known health and social problem worldwide. The nonsterile application of addicting drugs leads to severe life-threatening vascular complications. The femoral triangle is an easy target for this purpose. Groin necrotic fasciitis (NF) with vessel necrosis is a challenging diagnosis that requires prompt treatment. Case Report: A 44-year-old male intravenous drug user presented for a left groin pain. He was diagnosed by computed tomography scan to have necrotizing fasciitis. Urgent debridement was performed and identified infected and necrotic ruptured femoral vessels without active bleeding. Debridement with vessel ligation was performed, and delayed revascularization was planned. The patient was admitted six weeks later with a left fifth toe necrosis and delayed arterial revascularization was performed via extra-anatomic trans-obturator ilio-femoral anastomosis. The patient had a favorable follow-up. Conclusion: NF in intravenous drug abusers should always be taken into consideration when a patient presents with groin pain and swelling. Urgent surgical control should be established. Extra-anatomical trans-obturator ilio-femoral anastomosis is a good option for revascularization.
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