We hereby report a case of diffuse pelvic peritoneal involvement by immunoglobulin G4-related disease (IgG4-RD). Numerous pelvic masses and nodules showing delayed enhancement on enhanced abdominal CT were found to congregate in the pelvic organs of a 57-year-old female presenting with intestinal subocclusion. The differentiation between peritoneal IgG4-RD and pelvic peritoneal carcinomatosis was only made by histopathology and immunohistochemistry performed after surgical resection. Autoimmune pancreatitis represents the historical prototype of IgG4-RD, but the spectrum of manifestations involving various organs has expanded during the last decade. In this report, we shortly review this clinical entity.
Carcinoma/diagnosis ; Female ; Humans ; *Immunoglobulin G ; Immunohistochemistry ; Intestinal Obstruction/*etiology ; *Intestine, Small ; Middle Aged ; Paraproteinemias/*complications/diagnosis/pathology ; Peritoneal Diseases/*complications/diagnosis/pathology ; Peritoneal Neoplasms/diagnosis

No abstract available.
*Abdominal Wall ; Adult ; *Cesarean Section, Repeat ; Endometriosis/*diagnosis/etiology/pathology ; Female ; Humans ; Peritoneal Diseases/*diagnosis/pathology ; Postoperative Complications/*diagnosis/pathology ; Pregnancy ; Tomography, X-Ray Computed

Adolescent ; Diagnosis, Differential ; Endometriosis ; pathology ; Female ; Humans ; Melanoma ; pathology ; Melanosis ; complications ; pathology ; surgery ; Ovarian Neoplasms ; complications ; Peritoneal Diseases ; complications ; pathology ; surgery ; Teratoma ; complications

There are a variety of fat-containing lesions that can arise in the intraperitoneal cavity and retroperitoneal space. Some of these fat-containing lesions, such as liposarcoma and retroperitoneal teratoma, have to be resected, although resection can be deferred for others, such as adrenal adenoma, myelolipoma, angiomyolipoma, ovarian teratoma, and lipoma, until the lesions become large or symptomatic. The third group tumors (i.e., mesenteric panniculitis and pseudolipoma of Glisson's capsule) require medical treatment or no treatment at all. Identifying factors such as whether the fat is macroscopic or microscopic within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis. The development and wide-spread use of modern imaging modalities make identification of these factors easier so narrowing the differential diagnosis is possible. At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques. Thus, the questions about the treatment methods have become increasingly important. Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.
Abdominal Fat/pathology/radiography ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Neoplasms, Adipose Tissue/*pathology/*radiography ; Peritoneal Cavity/pathology/radiography ; Peritoneal Diseases/pathology/radiography ; Peritoneal Neoplasms/*pathology/*radiography ; Retroperitoneal Neoplasms/*pathology/*radiography ; Retroperitoneal Space/pathology/radiography ; Tomography, Spiral Computed/methods ; Young Adult

OBJECTIVETo assess the abdominal cocoon complicated with infertility using laparoscope and its clinical management.

METHODSSix cases of abdominal cocoon treated in our hospital from January 1998 to December 2002 were retrospectively reviewed.

RESULTSOf the 6 patients all with primary and tubal infertility, 3 received routine closed laparoscope operation, and other 3 failed for laparoscopy and were transferred to laparotomy. During the surgery it was found that the abdomen and pelvis were filled with multiple layer fibrous tissue which enveloped the bowel and reproductive organs, making exploration nearly impossible. It was difficult to ablate the envelope.

CONCLUSIONAbdominal cocoon can be diagnosed in those primary and tubal infertile patients when the charge is hindered in the process of laparoscope. The optimal treatment of the infertility for those patients is in vitro fertilization-embryo transfer.

Adult ; Female ; Fibrosis ; complications ; Humans ; Infertility, Female ; etiology ; Intestinal Obstruction ; diagnosis ; Intestine, Small ; pathology ; Laparoscopy ; Peritoneal Diseases ; complications ; Tissue Adhesions ; complications

Computed body tomography has become useful in the diagnosis of pancreatic disease. It was found to be are liable, often specific, and noninvasive method for detecting pancreatitis and extra-pancreatic extension of the pathology. Of eight hundred and seventy-two cases studied for abdominal pathology with EMI-CT 5005 whole body scanner form Oct. 1977 to August 1980, 21 cases were confirmed to be pancreatitis clinically or operatively. The authors reviewed the CT findings of the above cases and the results were as follows; 1. Among twenty-one cases, the acute pancreatitis was 12 cases and the chronic pancreatitis was 9 cases. The sex ratio as 17 males to females. 2. In acute pancreatitis, diffuse enlargement of pancreas (11/12), focal enlargement (1/12), loss of peripancreatic fat plane (9/12), thickening of anterior of pararenal fascia (6/12), and smooth margin ofpancreas (5/12) were observed. 3. In chronic pancreatitis, parenchymal atrophy (7/9), normal size (2/9), loss of peripancreatic fat plane (3/9), thickening of anterior pararenal fascia (1/9), calcification (1/9), smooth margin (2/9), and serrated margin (6/9) were observed. 4. The complications were associated with 7 cases of acute pancreatitis and 1 case of chronic pancreatitis; pseudocyst (6), abscess (2), and fat necrosis (3), The sites of the pseudocyst were lesser sac (2), anterior pararenal space (2), posterior pararenal space (1), subhepatic region (1), greater omentum (1), and intrapancreatic region (2). All of them were associated with acute pancreatitis except one in chronic pancreatitis.
Abscess ; Atrophy ; Diagnosis ; Fascia ; Fat Necrosis ; Female ; Humans ; Male ; Methods ; Omentum ; Pancreas ; Pancreatic Diseases ; Pancreatitis ; Pancreatitis, Chronic ; Pathology ; Peritoneal Cavity ; Sex Ratio

We report a rare case of giant mesenteric lipoma presenting with colicky abdominal pain. A 29-yr-old woman underwent laparoscopic resection for a giant mesenteric lipoma causing compression of the ileal loop. The resected ileal segment was encased by a giant fatty tissue, and normal mucosal fold patterns of the resected ileum were effaced by the mass. Microscopically, the mass was characterized by homogenous mature adipose tissue without cellular atypia, which was compatible with the diagnosis of a mesenteric lipoma. Despite the benign nature of this tumor, total excision with or without the affected intestinal loop should be considered if intestinal symptoms such as abdominal pain are present.
Abdominal Pain/*etiology ; Adipose Tissue/pathology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Ileal Diseases/etiology ; Laparoscopy ; Lipoma/complications/*diagnosis/surgery ; *Mesentery/pathology ; Peritoneal Neoplasms/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

Lower gastrointestinal complications often develop in end stage renal disease patients, and among the more problematic is recurrent colon ulcer. The exact pathogenesis of this condition is not known and there were no specific therapeutic modalities concerning this type of disease entity. We report, with a literature review, a case of recurrent colon ulcer with intermittent hematochezia in an end stage renal disease patient on long term hemodialysis that improved after conversion to peritoneal dialysis.
Aspirin/therapeutic use ; Colon/pathology ; Colonic Diseases/complications/*diagnosis/drug therapy ; Colonoscopy ; Drug Therapy, Combination ; Gastrointestinal Hemorrhage ; Humans ; Kidney Failure, Chronic/*complications ; Male ; Middle Aged ; Peritoneal Dialysis ; Recurrence ; Ticlopidine/therapeutic use ; Ulcer/complications/*diagnosis/drug therapy