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Since the advent of breast implants, there has been unprecedented controversy and FDA bands regarding their safety. There has been a demonstrated link with certain types of lymphoma, autoimmune disorders, and systemic illness associated with breast implants. A significant population of women currently pursue bilateral breast implant removal in hopes to alleviate a constellation of symptoms anecdotally known as “breast implant illness”. This is not yet an accepted clinical entity due to the lack of sound literature on the subject. Common presenting symptoms include fatigue, anxiety, chronic pain, endocrine, autonomic, and peripheral nervous system dysfunction. Currently, there is no standard of care or guideline for treating women experiencing such symptoms. The current literature regarding breast implant illness has been widely observational and descriptive. With over four million women across the globe with augmented breasts, the potential impact of this research is great. This paper presents three patients believed to be suffering from breast implant illness, who after en-bloc resection, experienced resolution of their symptoms.

Patient: Male, 52-year-old Final Diagnosis: Heterotopic ossificans Symptoms: Abdominal pain • bloating • obstipation Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Small bowel obstruction is a relatively uncommon cause of abdominal pain in the emergency department setting. However, patients with this pathology are almost uniformly admitted to the hospital, demonstrating its clinical importance in terms of diagnostic delays and risk of clinical demise. Case Report: This case report describes a patient who presented with a small bowel obstruction and no abdominal surgical or trauma history. The patient failed conservative management and proceeded to the operating room for diagnostic laparoscopy, which demonstrated a congenital band, a rare cause of bowel obstruction in the adult population. Surgical intervention was initially curative; however, the patient returned to the hospital 2 weeks later with concern for recurrent bowel obstruction. Despite computed tomography without any pathological lesion or lead point, the patient was taken back to surgery owing to high clinical concern, where an obstructing mass was found, and partial colectomy was performed. Pathological evaluation at the level of the obstruction demonstrated heterotopic mesenteric ossification, an exceedingly rare condition. This patient was managed at a community hospital general surgery program and, following 2 surgical interventions, had complete resolution of his symptoms. Conclusions: This case is unique in that it presents the surgical management of 2 uncommon conditions that occurred in a single patient. It further demonstrates the importance of clinical suspicion in the management of bowel obstruction. Further study of pathogenic congenital bands and heterotopic mesenteric ossification are required to truly understand etiology, workup, and appropriate treatment.

HighlightsMesenteric cysts are rare tumors of the gastrointestinal mesentery that are seldom symptomatic, often found incidentally.This is a rare case of a small mesenteric cyst presenting with abdominal pain secondary to intimate connection to the root of the mesentery.Including this study, multiple case reports and case series have been performed without consensus for best modality of treatment.This literature would benefit from a larger prospective study delineating treatment guidelines.