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  • Author or Editor: Jakub Kaczynski x
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We report a case of an elderly patient presenting with the left iliac fossa mass. The provisional diagnosis included an inflammatory diverticular mass or sigmoid colon cancer. Interestingly, computed tomography (CT) of the abdomen and pelvis demonstrated the left incarcerated Spigelian hernia containing an inflamed loop of the colon with signs of an early strangulation. However, at operation, a mucinous tumor was found involving the descending and upper sigmoid colon. The tumor eroded through the anterior abdominal wall, which was excised “en bloc.” In the presented case, CT findings suggestive of a benign etiology were misleading. This potentially could have had significant consequences if the patient was treated conservatively.

This case highlights that clinical history and examination remain the core components of a safe surgical practice. Clinical judgment cannot be substituted even by the best quality imaging.

Therefore, we feel that it is important to share our experience of the successful management of the presented case.

Open access

We present a case of a middle-aged female who attended for a routine laparoscopic cholecystectomy as a day case surgery. At operation, she was found to have a distended gallbladder with an unusually prominent distal portion. This has made the dissection of the Calot’s triangle challenging. As a result, the “critical view of safety” technique was applied. This allowed for the clear Calot’s triangle visualization and identification of the cystic duct and artery. This case highlights that the knowledge of various ways of the cystic duct dissection is essential to every surgeon. Furthermore, this helps to adjust the dissection approach on an individual case bases ensuring avoidance of the common bile duct injuries.

Open access

Abstract

Ischemic colitis is the most common form of an iatrogenic intestinal ischemia following an aortic surgery. It can be transient and self-limiting but, when severe, is associated with mortality even as high as 80%. Careful preoperative assessment can help to anticipate the need for the inferior mesenteric artery (IMA) reimplantation. Some patients lack the sufficient collateral blood supply to the colon and can benefit from the IMA reimplantation, which not only reduces the risk of postoperative colonic necrosis but also can be lifesaving. We report a case of a successful reimplantation of the IMA based on the careful preoperative planning. If unrecognized, this undoubtedly would lead to postoperative colonic ischemia. Therefore, we feel it is important to share our experience regarding the successful management of the presented case.

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