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Autoamputated Leiomyoma of the Uterus as a Rare Cause of the Mechanical Bowel Obstruction – Report of a Case

100%

Rubinkiewicz M., Kenig J., Zbierska K., Lasek A.

Polish Journal of Surgery

2015

vol. 86

issue 7

341-344

Mechanical obstruction of the gastrointestinal tract is one of the most common causes of the emergency surgical intervention. A rare cause of such condition might be the effect of the external pressure on the intestine exerted by i. e. tumor, lymph node package, aneurysm of the abdominal aorta. An extremely rare cause is the pressure of the large loose mass located in the peritoneal cavity called “loose body”. We present a case of the mechanical bowel obstruction caused by a giant loose autoamputated leiomyoma of the uterus lying free in the peritoneal cavity. According to our best knowledge it is the largest described loose body in the literature. Moreover, we present a literature review regarding this issue.

Preoperative pancreatic duct stenting in patients undergoing laparoscopic pancreatic surgery – a preliminary report

76%

Rubinkiewicz M., Migaczewski M., Pędziwiatr M., Matłok M., Dembiński M., Budzyński A.

Polish Journal of Surgery

2015

vol. 87

issue 6

307-311

Laparoscopic surgery is becoming an approved technique in pancreatic surgery. It offers some advantages over an open approach due to shorter hospital stay and decreased complication rate. Regardless the technique the most significant problem of pancreatic surgery is postoperative pancreatic fistula. There are numerous methods attempted at reduction of its incidence. One of the possibilities is preoperative pancreatic duct stenting. It aims at decreasing the pressure in the pancreatic duct, which is supposed to facilitate pancreatic juice flow to the duodenum. The aim of the study was to determine the role of preoperative pancreatic duct stenting in pancreatic surgery. Material and methods. Nineteen patients undergoing laparoscopic pancreatic resection were enrolled into the study. Prior to the surgery, all of the patients were submitted for the Endoscopic Retrograde Choleangiopancreatography (ERCP) with pancreatic duct stenting. Following the subsequent laparoscopic pancreatic resection, all patients were monitored to detect the pancreatic fistula appearance. The pancreatic stent was removed 6‑8 weeks after the surgery. Results. With an exception of two patients, all other patients underwent successful ERCP with pancreatic duct stenting before the surgery. In one case the placement of the prosthesis failed due to a tortuous pancreatic duct. Five patients had an episode of acute pancreatitis including two severe courses as a complication of preoperative ERCP. One of the patient died due to severe GI bleeding 2 weeks after stenting. Among the procedures there were 15 distal pancreatectomies, two enucleations of the tumor localized in the uncinate process and in the body of the pancreas and one central pancreatectomy. The median time of surgery duration was 186 minutes (90‑300; ±56). No conversions to an open approach were necessary. Likewise, there was neither any major complications reported in a postoperative course nor incidence of pancreatic fistula in any of the patients undergoing surgery. Conclusions. Preoperative pancreatic duct stenting can decrease the incidence of pancreatic fistula. However, a number of serious complications exceed the potential benefit of this method.

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2 Polish Journal of Surgery

1 2015

1 2014

2 Rubinkiewicz M.

1 Budzyński A.

1 Dembiński M.

1 Kenig J.

1 Lasek A.

1 Matłok M.

1 Migaczewski M.

1 Pędziwiatr M.

1 Zbierska K.

Search results

Autoamputated Leiomyoma of the Uterus as a Rare Cause of the Mechanical Bowel Obstruction – Report of a Case

Preoperative pancreatic duct stenting in patients undergoing laparoscopic pancreatic surgery – a preliminary report