Surgery today
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An 80-year-old woman presented to our outpatient center with abdominal pain and blood-stained stools. She underwent a colonoscopy, which showed a 4-cm type II tumor in the rectum. About 2 h after the colonoscopy, mild facial edema and subcutaneous emphysema developed around her neck. ⋯ The air seemed to have leaked from a 2-cm inflamed diverticulum in the sigmoid colon. The mesosigmoid was also expanded by air. We discuss the anatomical mechanism of the various clinical presentations of extraluminal air following colonoscopy.
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A 36-year-old woman without any relevant medical history was admitted to our hospital with an abdominal tumor that had caused recurrent right hypochondral and back pain for 3 months. Retroperitoneal cystic lymphangioma was diagnosed by abdominal ultrasonography and computed tomography. ⋯ Most patients experience chronic symptoms, necessitating therapeutic intervention. Excision is the treatment of choice, and can be performed laparoscopically in selected patients.
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Case Reports
Stanford type A aortic dissection which ruptured into the left atrium: report of a case.
A Stanford type A aortic dissection ruptures usually into the pericardial space or the mediastinal space. We herein report the rare surgical case of a Stanford type A aortic dissection which ruptured into the left atrium. ⋯ At operation, adhesions around the proximal aorta and between the aortic root and the left atrial roof were confirmed to be one of the causes for this rare form. A fistula to the cardiac cavity following an aortic dissection may occur in any patient, especially in those with a history of previous cardiac surgery.
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We investigated the postoperative complications that developed in patients who underwent surgery after induction chemotherapy (IC) for primary lung cancer. ⋯ These findings indicate the feasibility of treating primary lung cancer with IC followed by surgery as long as a cautious operative procedure is used and careful postoperative management is given, paying particular attention to the risk of ARDS and bronchial complications.
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Review Case Reports
Primary cutaneous mucormycosis in an immunocompetent host: report of a case.
Cutaneous mucormycosis is an uncommon disease and it usually affects immunocompromised, diabetic, and trauma patients with contaminated wounds or patients with underlying malignancies. It is very rare to find this disease in immunocompetent, nondiabetic patients. We herein report a case of primary cutaneous mucormycosis in an immunocompetent and nondiabetic patient. ⋯ He was diagnosed to have cutaneous mucormycosis of the anterior abdominal wall, and was treated with multiple debridements of the wound and intravenous amphotericin B therapy. He received a total of 1000 mg of amphotericin B. A high index of clinical suspicion and early institution of therapy in the form of surgical debridements and antifungal drugs are required to achieve a successful outcome.