Design and Methods: TF, a 12-year-old male, presented to the surgical outpatient clinic with a 3 month history of abdominal pain and distention. Examination of the abdomen revealed mild tenderness in the epigastric region and an abdominal mass. CT scan of the abdomen and pelvis showed two mesenteric cysts with the largest being 15cm x 10cm x 6 cm. Results: Both cysts originated from the small bowel mesentery and they were resected laparoscopically, placed in an endocatch bag and removed by way of the 12mm umbilical port site. Histologic evaluation of the specimen confirmed cystic lymphangioma. Conclusion: Minimally invasive surgery has been found to be an excellent approach in the surgical management of mesenteric cysts. The operation was executed without complications, an unremarkable recovery, short hospital stay and quick return to normal activity. The laparoscopic approach should always be considered as a feasible option for this pathology.
Meckel's diverticulum (MD) is the commonest congenital anomaly of the small intestine, affecting 1-4% of the population. Cardinal features emphasise an antimesenteric location two feet proximal to the ileocaecal valve, with a separate mesenteric blood supply and involvement of all layers of the small intestine. However, reports of MD arising from the mesenteric border of the small intestine are rare in the surgical literature. This report examines the case of a 45-year-old woman presenting with a 6-month history of episodic central abdominal pain and microcytic anaemia who underwent an elective diagnostic laparoscopy as initial CT findings were inconclusive. Intraoperatively, she was found to have small bowel intussusception approximately 40 cm proximal to the ileocaecal valve. Macroscopic examination of the resected small bowel segment revealed a mesenteric outpouching that was confirmed as mesenteric MD on histopathological analysis. Postoperatively, the patient recovered with no surgical complications and full symptom resolution.
Anorectal motor, sensory and reflex abnormalities are seen in distinct patterns in patients with FI and constipation. This would suggest distinct physiological differences that may predict the potential for different neuromodulation treatment and behavioral modalities in these conditions.
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