1/12. Preoperative sonographic diagnosis of midgut malrotation with volvulus in adults: the "whirlpool" sign.Midgut malrotation and volvulus, found mostly in children, are rare and difficult to diagnose preoperatively in adults. We report 2 cases in which a 68-year-old man and a 75-year-old woman presented with intermittent cramping abdominal pain, abdominal distention, and vomiting. Abdominal sonography demonstrated wrapping of the superior mesenteric vein and bowel loops around the superior mesenteric artery (the "whirlpool sign") in both patients. Abdominal CT revealed similar findings. The diagnoses of midgut volvulus and mesenteric malrotation were made, and the patients underwent laparotomy. The man was confirmed to have duodenojejunal malrotation and volvulus, and the woman had cecal volvulus. The whirlpool sign is valuable for the preoperative diagnosis of mesenteric vessel malrotation and midgut volvulus.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/12. Massive intraperitoneal bleeding from tryptic erosions of the splenic vein. Another cause of sudden deterioration during recovery from acute pancreatitis.Acute bleeding is a rare, but frequently fatal complication of pancreatitis. Bleeding into the gastrointestinal tract may occur owing to gastric or duodenal erosions, peptic ulcers, or varices in the esophagus, stomach, or colon following splenic vein thrombosis, or intraperitoneally from eroded vessels in pancreatic pseudocysts or expanding pseudoaneurysms. We report a novel case of massive intraperitoneal bleeding owing to tryptic erosions of the splenic vein in a patient recovering from acute pancreatitis. diagnosis of the bleeding was made by ultrasound and ultrasound-guided blood aspiration. The source of the bleeding was identified intraoperatively, and a left-sided pancreatectomy and a splenectomy were performed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/12. Localized Castleman's disease presenting as a vascular right iliac fossa mass.Castleman's disease is a rare lymphoproliferative disorder of unknown aetiology. The presentation is varied, diagnosis is difficult, and optimum management is still unknown. We report our experience with a case of Castleman's disease in a 34-year old woman who presented with pallor, hepatosplenomegaly, and a right iliac fossa mass that was 5 cm in diameter. this was initially diagnosed as a soft tissue sarcoma and preoperative tumour embolization was planned before excision. Mesenteric arteriogram revealed that the feeder arteries arose from the superior mesenteric artery and embolization was aborted for fear of causing bowel ischaemia. On laparotomy, lymphoid enlargement was found between the leaves of the jejunal mesentery. The tumour was relatively avascular and the overlying mesenteric vessels contributed to teh duplex ultrasound and computerized tomography appearance of hypervascularity. The tumour with the mesentery and the overlying segment of jejunum was excised completely. Histopathology confirmed Castleman's disease. The purpose of this report is to present this rare case that caused a diagnostic dilemma and to review the management of this disorder.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/12. Omental torsion: CT features.A 33-year-old male presented to the emergency department complaining of right upper quadrant pain and was initially diagnosed with acute cholecystitis. Abdominal computed tomography showed a whirling pattern of fatty streaks and vessels within the greater omentum, and surgery confirmed infarction of the omentum secondary to torsion. We report a case of surgically and pathologically proven omental torsion that demonstrated the typical whirling appearance on computed tomography.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/12. Portal hypertensive hemorrhage from a left gastroepiploic vein caput medusa in an adhesed umbilical hernia.Caput medusa is a frequent incidental finding in patients with portal hypertension that usually represents paraumbilical vein portosystemic collateral vessels draining into body wall systemic veins. A symptomatic caput medusa was seen in a morbidly obese patient after an umbilical hernia repair, which was fed not by the left portal vein but by the left gastroepiploic vein, in a recurrent adhesed umbilical hernia that likely contained herniated omentum. Refractory hemorrhage from this caput medusa was successfully treated by transjugular intrahepatic portosystemic shunt creation and balloon-occluded variceal sclerosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/12. A case of Castleman's disease arising from the lesser omentum.A 29-year-old female presented with upper abdominal pain. An upper gastrointestinal radiograph and endoscopy revealed an extra compression in the lesser curvature of the body of the stomach. A computed tomography scan and magnetic resonance imaging revealed a tumor located between the left lobe of the liver and the lesser omentum of the stomach. F-18 fluorodeoxyglucose positron emission tomography revealed high uptake at the tumor in the upper abdomen. In an angiogram, a large hypervascular mass had a prominent vascular supply from the left gastric artery; venous pooling and an enlarged feeding vessel were also apparent. From these results, we suspected that the patient had Castleman's disease arising from the lesser omentum. The patient underwent hand-assisted laparoscopic tumor resection. The resected tumor was an encapsulated mass, the surface of which was smooth and the dimensions of which were 77 x 51 x 43 mm. Based on microscopic findings, we diagnosed hyaline vascular type Castleman's disease. Since surgical intervention, the patient has remained asymptomatic, with no pathologic clinical or laboratory findings. Castleman's disease that occurs in the lesser omentum is extremely rare, and the preoperative diagnosis is very difficult. For the localized type of Castleman's disease, clinical findings are usually improved by complete surgical resection.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/12. Omental torsion.A 65-year-old man presented to the emergency department complaining of right lower abdominal pain. Abdominal computed tomography showed a whirling pattern of fatty streaks and vessels in the greater omentum. From this typical finding, a diagnosis of omental torsion was made immediately, which was confirmed by subsequent surgery. We report a case of surgically and pathologically proven omental torsion that demonstrated a typical appearance on computed tomography and was diagnosed preoperatively.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/12. Omental herniation through the foramen of Morgagni. diagnosis with chest computed tomography.The fat accumulation most frequently seen in the peridiaphragmatic areas represents herniations of abdominal fat or epicardial fat pad. We present a patient with a large fatty mass after 10 months of corticosteroid therapy in which computed tomography demonstrated omental vessels, thus proving that it was omental herniation through Morgagni's foramen.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/12. Intraabdominal bleeding from variceal vessels in cirrhosis.A cirrhotic patient with hemoperitoneum was found, at laparotomy, to be bleeding from variceal vessels in the peritoneum lateral to the ascending colon. Radiological in vestigations before surgery did not identify the source of blood loss. Despite hemostasis being obtained, the patient died postoperatively. The 5 previously reported cases of intraabdominal bleeding from variceal vessels are reviewed.- - - - - - - - - - ranking = 6keywords = vessel (Clic here for more details about this article) |
10/12. Massive traumatic hemomentocele.A case is reported of a massive hemomentocele caused by rupture of the left gastroepiploic vessels following blunt abdominal trauma. This injury is previously unreported. Peritoneal aspiration is the simplest method of confirming that intraabdominal bleeding has occurred, but more sophisticated investigations may be needed to diagnose covert trauma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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