Rosai-Dorfman disease (RDD) is a rare proliferative histiocytic disorder, most commonly presenting with cervical lymphadenopathy. When extranodal, a rare manifestation of the disease is the presence of cutaneous lesions. Surgical excision has shown promising results in patients with cutaneous RDD; however, no optimal management has been elucidated. We present a 60-year-old female with recurrence of left thigh cutaneous lesions consistent with extranodal RDD whose optimal management required combined used of excision and chemotherapy.
Gastric volvulus is a rare entity with the potential to become a surgical emergency if vital vascular supply is compromised. We present a case of a patient who underwent laparoscopic cholecystectomy converted to open; and after multiple admissions for intractable vomiting, she was found to have a secondary gastric volvulus during subsequent exploratory laparotomy. Due to dense adhesions, complete detorsion was deemed unsafe for the patient and a gastrojejunal bypass was created with subsequent complete resolution of symptoms. Patient has been doing well in follow-up visits.
Laparoscopic entry into the abdomen with subsequent insufflation can be achieved via an open or closed approach. A risk that is often overlooked as a result of its rarity is a venous air embolism (VAE) from carbon dioxide (CO 2 ) insufflation. Although both closed and open techniques of entry into the abdomen contribute to an extremely low risk for VAE, when the effects are clinically significant the mortality rate has been reported to be as high as 28%. In this report we present a case of a 64-year-old female who underwent a closed approach for entry into the abdomen for elective hepatic cystectomy, who subsequently went into cardiopulmonary arrest and was found to have imaging findings suggestive of VAE localized to the portal vein. Successful management decisions presented in this case report will serve as possible options for physicians to employ when encountering a similar intraoperative complication.
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