Female ; Humans ; Laparoscopy ; Ovarian Cysts/surgery* ; Pregnancy ; Pregnancy Trimester, Third ; Torsion Abnormality/surgery*

Abdomen, Acute ; diagnosis ; Adult ; Female ; Humans ; Laparoscopy ; methods ; Omentum ; pathology ; surgery ; Torsion Abnormality ; diagnosis ; surgery

A 72-year-old man with jaundice by ampullary adenocarcinoma was treated at our hospital. For biliary decompression, a transpapillary, fully covered, self-expandable metal stent (FCSEMS) was deployed. Four days later, the patient developed acute cholangitis. Endoscopic carbon dioxide cholangiography revealed kinking of the common bile duct above the proximal end of the FCSEMS. A 7-F double-pigtail plastic stent was therefore placed through the FCSEMS to correct the kink, straightening the common bile duct (CBD) and improving cholangitis. This is the first report of a unique use of a double-pigtail plastic stent to correct CBD kinking. The placement of a double-pigtail plastic stent can correct CBD kinking, without requiring replacement or addition of a FCSEMS, and can lead to cost savings.
Aged ; Common Bile Duct/*injuries ; Constriction, Pathologic/surgery ; Decompression, Surgical/instrumentation/methods ; Humans ; Male ; Self Expandable Metallic Stents/adverse effects ; *Stents ; Torsion Abnormality/*surgery

We describe a rare case of extralobar pulmonary sequestration with hemorrhagic infarction in a 10-year-old boy who presented with acute abdominal pain and fever. In our case, internal branching linear architecture, lack of enhancement in the peripheral portion of the lesion with internal hemorrhage, and vascular pedicle were well visualized on preoperative magnetic resonance imaging that led to successful preoperative diagnosis of extralobar pulmonary sequestration with hemorrhagic infarction probably due to torsion.
Abdominal Pain/etiology ; Bronchopulmonary Sequestration/*diagnosis/surgery ; Child ; Fever/etiology ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Pulmonary Infarction/*diagnosis/surgery ; Torsion Abnormality/complications

Wandering spleen or splenoptosis is an uncommon entity and often an asymptomatic finding of acute abdomen in the emergency department. A high index of suspicion for splenic torsion is required, particularly in patients with known splenomegaly, as this condition could potentially lead to splenic infarction. Recognition of this condition can help avoid potential confusion with acute abdomen of other aetiologies. Herein, we present a unique case of wandering spleen with chronic torsion, which, to the best of our knowledge, has never been described in an elderly patient with haemoglobin H thalassaemia. We also review the literature for the aetiology and pathogenesis of wandering spleen, and discuss the relevant diagnostic modalities and treatment options.
Abdominal Pain ; Aged ; China ; ethnology ; Female ; Hospitals ; Humans ; Singapore ; Thalassemia ; Tomography, X-Ray Computed ; Torsion Abnormality ; complications ; diagnosis ; surgery ; Wandering Spleen ; complications ; diagnosis ; surgery

Leiomyomatosis peritonealis disseminata is usually asymptomatic or mimics widespread malignancy; acute presentation is rare. We describe a patient with right iliac fossa and lower abdominal pain. Two masses were detected via computed tomography, but at surgery, one of these implanted leiomyomas had undergone acute omental torsion. This case illustrates a rare complication of omental leiomyoma torsion clinically mimicking acute appendicitis.
Adult ; Diagnosis, Differential ; Female ; Humans ; Leiomyomatosis ; complications ; diagnosis ; Omentum ; pathology ; Peritoneal Neoplasms ; complications ; diagnosis ; Tomography Scanners, X-Ray Computed ; Torsion Abnormality ; etiology ; surgery

BACKGROUNDAppendectomy is the traditional surgical procedure for correcting torsion of the adnexa. Although it prevents pulmonary embolism, ovarian necrosis, and secondary infection, it can have critical adverse effects on the ovarian function.

METHODSWe performed surgery for adnexal torsion in 12 patients, using high ligation of the ovarian vein, followed by removal of the ovarian tumor.

RESULTSBlood flow in the residual ovary gradually returned to normal within 1 - 3 months, and a dominant follicle could be seen in the residual ovary within 2 - 6 months post-surgery in all the 12 cases. Menstruation recovered in these three cases within 2 - 3 months. Postoperative intrauterine pregnancies occurred in two cases, with a corpus luteum graviditatis in the residual ovary in one case, while the other patient underwent labor after 13 months and a normal ovary on the affected side was seen at cesarean section.

CONCLUSIONSThis new surgical technique involving high ligation of the ovarian vein for adnexal torsion allowed successful preservation of the residual ovary and ovarian blood distribution, and can thus be used for the treatment of primary diseases of the ovary. The surgical procedure is simple, safe, and effective, and warrants extensive application in clinical practice.

Adolescent ; Adult ; Female ; Humans ; Ligation ; Ovarian Neoplasms ; physiopathology ; surgery ; Ovary ; blood supply ; physiopathology ; Torsion Abnormality ; surgery ; Ultrasonography, Doppler, Color

INTRODUCTIONThe purpose of this case series was to determine the sonographic features of neonatal ovarian torsion.

MATERIALS AND METHODSSeven surgically proven cases of neonatal ovarian cysts were included in this retrospective study. The patients were divided into 2 groups, torsion and non-torsion. These 7 patients were evaluated for the clinical presentation, sonographic features, surgical and pathological findings. The findings on follow-up sonography after surgery were also noted.

RESULTSThe sonographic appearance was variable. Of the 4 cases with torsion, 2 lesions had internal echoes with 'fi sh-net appearance'. The other 2 lesions were predominantly cystic on the sonography with internal echoes and echogenic nodule. A calcific focus was present in 1 of these echogenic nodules. One of the cysts had fluid-fluid level. In the non-torsion group, only 1 lesion had mixed echogenic appearance. The other 2 lesions were cystic with low level internal echoes in 1 of the cysts. The surgical procedure performed in the torsion group was salpingo-oophorectomy in 2 patients and oophorectomy in 1 patient. In 1 patient, cystectomy was attempted without success. In the non-torsion group, only cystectomy was performed with preservation of normal ovaries, which was confirmed on follow-up sonography.

CONCLUSIONThe sonographic features of cysts with 'fish-net appearance', fluid-debris level and cysts with echogenic nodule favour torsion. The former sign has so far not been described as a sonographic predictor for neonatal ovarian torsion.

Female ; Humans ; Infant, Newborn ; Ovarian Cysts ; diagnostic imaging ; pathology ; surgery ; Ovary ; diagnostic imaging ; pathology ; Postoperative Period ; Retrospective Studies ; Torsion Abnormality ; diagnostic imaging ; pathology ; surgery ; Ultrasonography, Doppler ; instrumentation

Abdominal Pain ; diagnostic imaging ; etiology ; surgery ; Adult ; Humans ; Laparoscopy ; Male ; Omentum ; Peritoneal Diseases ; complications ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Torsion Abnormality

No abstract available.
Adult ; Female ; Humans ; Meckel Diverticulum/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; Torsion Abnormality