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Gkionis IG, Kokkinakis TG, Strehle AF, Flamourakis ME, Giakoumakis MI, Mannaris MA, Kaloeidi EI, Apostolaki ES, Christodoulakis MS, Laliotis A. An unusual case of mechanical bowel obstruction due to cholecysto-intestinal fistula and impacted gallstone: A case report and literature review. SAGE Open Med Case Rep 2023; 11:2050313X231153756. [PMID: 36776205 PMCID: PMC9909047 DOI: 10.1177/2050313x231153756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 01/11/2023] [Indexed: 02/10/2023] Open
Abstract
Gallstone ileus is a rare entity and constitutes an uncommon complication of gallstone disease. It is caused by the impaction of a gallstone in the gastrointestinal tract and may cause serious symptoms or even life-threatening complications. It should be part of the differential diagnosis of acute abdomen especially in patients presenting with signs and symptoms of bowel obstruction and known gallstone disease. An early diagnosis is essential, and surgical treatment is the gold standard in order to relieve the obstruction. We present the case of an 84-year-old male patient with gallstone ileus due to cholecysto-intestinal fistula and impacted gallstone at jejunum. He was treated via urgent enterolithotomy, and his post-operative period was uneventful. This report aims to further educate clinical doctors on this rare medical condition which may pose a potentially serious health risk.
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Affiliation(s)
- Ioannis G Gkionis
- Department of General Surgery, Venizeleio General Hospital, Heraklion, Greece,Ioannis G Gkionis, Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion 71409, Greece.
| | | | - Andreas F Strehle
- Department of General Surgery, Venizeleio General Hospital, Heraklion, Greece
| | | | | | - Marios A Mannaris
- Department of General Surgery, Venizeleio General Hospital, Heraklion, Greece
| | - Eleni I Kaloeidi
- Department of General Surgery, Venizeleio General Hospital, Heraklion, Greece
| | | | | | - Aggelos Laliotis
- Department of General Surgery, Venizeleio General Hospital, Heraklion, Greece
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Gkionis IG, Flamourakis ME, Strehle AF, Karafoulidou ZI, Kostakis GE, Spiridakis KG, Laliotis A, Giakoumakis MI, Christodoulakis MS. A Rare Case of Extended Retroperitoneal Biloma Due to Spontaneous Perforation of Common Bile Duct, Mimicking a Strangulated Right Inguinal Hernia: A Case Report and Literature Review. Am J Case Rep 2022; 23:e936255. [PMID: 35754151 PMCID: PMC9246215 DOI: 10.12659/ajcr.936255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patient: Male, 89-year-old
Final Diagnosis: Bile duct injury • retroperitoneal biloma
Symptoms: Diffuse abdominal pain • fatigue • nausea • vomiting
Medication: —
Clinical Procedure: —
Specialty: Surgery
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Affiliation(s)
- Ioannis G. Gkionis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Mathaios E. Flamourakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Andreas F. Strehle
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Zafeiro I. Karafoulidou
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Georgios E. Kostakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | | | - Aggelos Laliotis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Michail I. Giakoumakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
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Delimpaltadaki DG, Gkionis IG, Flamourakis ME, Strehle AF, Bachlitzanakis EN, Giakoumakis MI, Christodoulakis MS, Spiridakis KG. A rare giant gastric trichobezoar in a young female patient: Case report and review of the literature. Clin Case Rep 2021; 9:e05152. [PMID: 34938545 PMCID: PMC8665721 DOI: 10.1002/ccr3.5152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/07/2021] [Accepted: 11/19/2021] [Indexed: 12/13/2022] Open
Abstract
A bezoar is an aggregate of undigested foreign materials that accumulate in the gastrointestinal tract and may cause serious symptoms or even life-threatening complications. Trichobezoars, a subtype of bezoars, are a rare condition usually occurring in females with psychiatric disorders, with Rapunzel syndrome being an uncommon form of trichobezoar.
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Moniakis AA, Flamourakis ME, Gkionis IG, Giakoumakis MI, Tsagkataki ES, Kazamias GM, Spiridakis KG, Christodoulakis MS. Ileocolic Intussusception in a Woman: A Case Report and Literature Review. Am J Case Rep 2021; 22:e933341. [PMID: 34623978 PMCID: PMC8515498 DOI: 10.12659/ajcr.933341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Intussusception is a rare pathological entity in adults and remains a diagnostic challenge for clinicians, as it shares many clinical signs and symptoms with other morbid conditions (including appendicitis, abdominal hernias, colic, volvulus, and Meckel diverticulum). High clinical suspicion and use of appropriate imaging techniques are essential for early diagnosis and treatment of intussusception. Surgical intervention is the treatment of choice in cases of sustained and persistent invagination. CASE REPORT We present the case of a 65-year-old woman with a medical history of Crohn's disease, diabetes mellitus type II, hypertension, and rheumatoid arthritis. She was hospitalized for diarrhea, fatigue, and anemia. Computerized tomography of the abdomen and a colonoscopy revealed telescoping of the ileum, ileocecal valve, and part of the ascending colon inside the terminal segment of the ascending colon. The antegrade ileocolic intussusception was treated by performing a right hemicolectomy. The pathologic examination of the excised intestine showed mucosal lesions compatible with Crohn's disease, an inflammatory fibroid polyp at the terminal section of the ileum, and a low-grade appendiceal mucinous neoplasm. CONCLUSIONS Regardless of the etiology, when the normal motility of the intestine is altered, it can lead to invagination. Although intussusception is rare, it must always be part of the differential diagnosis for a patient presenting with constant abdominal pain.
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Affiliation(s)
- Alexandros A Moniakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Mathaios E Flamourakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Ioannis G Gkionis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Michail I Giakoumakis
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Eleni S Tsagkataki
- Department of General Surgery, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Georgios M Kazamias
- Department of Pathology, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece
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Tsagkataki ES, Flamourakis ME, Gkionis IG, Giakoumakis MI, Delimpaltadakis GN, Kazamias GM, Giannikaki ES, Christodoulakis MS. Gastric glomus tumor: a case report and review of the literature. J Med Case Rep 2021; 15:415. [PMID: 34392835 PMCID: PMC8365960 DOI: 10.1186/s13256-021-03011-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/12/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Gastric glomus tumor is a rare mesenchymal neoplasm. There are only a few cases of the tumor showing malignancy, and there are no specific guidelines for the management of this entity. Case presentation We present the case of a 53-year-old Caucasian male who was hospitalized for anemia. Computerized tomography of the abdomen depicted a mass between the pylorus of the stomach and the first part of the duodenum. Preoperative diagnosis was achieved with pathology examination of the biopsies taken via endoscopic ultrasound and upper gastrointestinal endoscopy. An antrectomy with Roux-en-Y anastomosis and appendicectomy, due to suspicion of appendiceal mucocele, were performed. The patient had an uneventful postoperative recovery and was discharged 5 days later. Discussion Preoperative diagnosis of a gastric glomus tumor is difficult owing to the location of the tumor and the lack of specific clinical and endoscopic characteristics. Furthermore, it is exceptional to establish diagnosis with biopsies taken through endoscopic ultrasound or upper gastrointestinal endoscopy, prior to surgical resection. Although most glomus tumors are benign and are not known to metastasize, there are rare examples of glomus tumors exhibiting malignancy. Treatment of choice is considered wide local excision with negative margins. However, long-term follow-up is required as there is the possibility of malignancy. Conclusion The aim of this report is to enlighten doctors about this uncommon pathologic entity. Surgical resection is considered the golden standard therapy to establish a diagnosis and evaluate the malignant potential.
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Affiliation(s)
- Eleni S Tsagkataki
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, 71409, Heraklion, Crete, Greece
| | - Mathaios E Flamourakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, 71409, Heraklion, Crete, Greece
| | - Ioannis G Gkionis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, 71409, Heraklion, Crete, Greece.
| | - Michail I Giakoumakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, 71409, Heraklion, Crete, Greece
| | - Georgios N Delimpaltadakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, 71409, Heraklion, Crete, Greece
| | - Georgios M Kazamias
- Department of Pathology, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Elpida S Giannikaki
- Department of Pathology, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Manousos S Christodoulakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, 71409, Heraklion, Crete, Greece
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Spiridakis KG, Flamourakis ME, Gkionis IG, Kaloeidi EI, Fachouridi AI, Konstantoulaki SE, Tsagkataki ES, Giakoumakis MI, Vassilogiannakis EA, Kostakis GE, Christodoulakis MS. Right-sided strangulating diaphragmatic hernia in an adult without history of trauma: a case report. J Med Case Rep 2021; 15:372. [PMID: 34256846 PMCID: PMC8278739 DOI: 10.1186/s13256-021-02861-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background Diaphragmatic hernia involves protrusion of abdominal contents into the thorax through a defect in the diaphragm. This defect can be caused either by developmental failure of the posterolateral foramina to fuse properly, or by traumatic injury of the diaphragm. Left-sided diaphragmatic hernias are more common (80–90%) because the right pleuroperitoneal canal closes earlier and the liver protects the right diaphragm. Diaphragmatic hernias in adults are relatively asymptomatic, but in some cases may lead to incarcerated bowel, intraabdominal organ dysfunction, or severe pulmonary disease. The aim of this report is to enlighten clinical doctors about this rare entity that can have fatal consequences for the patient. Case presentation We present a rare case of a right-sided strangulating diaphragmatic hernia in an adult Caucasian patient without history of trauma. Clinical examination revealed bowel sounds in the right hemithorax, which were confirmed by the presence of loops of small intestine into the right part of the thorax through the right diaphragm, as was shown on chest X-ray and computerized tomography. Deterioration of the clinical status of the patient led to an operation, which revealed strangulated necrotic small bowel. Approximately 1 m of bowel was removed, and laterolateral anastomosis was performed. The patient had an uneventful postoperative recovery and was discharged 8 days later. Conclusions Surgery is required to replace emerged organs into the abdomen and to repair diaphragmatic lesion. A delayed approach can have catastrophic complications for a patient.
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Affiliation(s)
- Konstantinos G Spiridakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece.
| | - Mathaios E Flamourakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Ioannis G Gkionis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Eleni I Kaloeidi
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Anthoula I Fachouridi
- Department of Imaging, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Styliani E Konstantoulaki
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Eleni S Tsagkataki
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Michail I Giakoumakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | | | - Georgios E Kostakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Manousos S Christodoulakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
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Gkionis IG, Flamourakis ME, Tsagkataki ES, Kaloeidi EI, Spiridakis KG, Kostakis GE, Alegkakis AK, Christodoulakis MS. Multidimensional analysis of the learning curve for laparoscopic colorectal surgery in a regional hospital: the implementation of a standardized surgical procedure counterbalances the lack of experience. BMC Surg 2020; 20:308. [PMID: 33267802 PMCID: PMC7709341 DOI: 10.1186/s12893-020-00975-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/19/2020] [Indexed: 12/18/2022] Open
Abstract
Background Although a larger proportion of colorectal surgeries have been performed laparoscopically in the last few years, a steep learning curve prevents us from considering laparoscopic colorectal surgery as the gold standard technique for treating disease entities in the colon and rectum. The purpose of this single centre study was to determine, using various parameters and following a well-structured and standardized surgical procedure, the adequate number of cases after which a single surgeon qualified in open surgery but with no previous experience in laparoscopic colorectal surgery and without supervision, can acquire proficiency in this technique. Methods From 2012 to 2019, 112 patients with pathology in the rectum and colon underwent laparoscopic colorectal resection by a team led by the same surgeon. The patients were divided into two groups (group A:50 – group B:62) and their case records and histopathology reports were examined for predefined parameters, statistically analysed and compared between groups. Results There was no significant difference between groups in the distribution of conversions (p = 0.635) and complications (p = 0.637). Patients in both groups underwent surgery for the same median number of lymph nodes (p = 0.145) and stayed the same number of days in the hospital (p = 0.109). A statistically important difference was found in operation duration both for the total (p = 0.006) and for each different type of colectomy (sigmoidectomy: p = 0.026, right colectomy: p = 0.013, extralevator abdominoperineal resection: p = 0.050, low anterior resection: p = 0.083). Conclusions Taking into consideration all the parameters, it is our belief that a surgeon acquires proficiency in laparoscopic colorectal surgery after performing at least 50 diverse cases with a well structured and standardized surgical procedure.
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Affiliation(s)
- Ioannis G Gkionis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece.
| | - Mathaios E Flamourakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Eleni S Tsagkataki
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Eleni I Kaloeidi
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Konstantinos G Spiridakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | - Georgios E Kostakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
| | | | - Manousos S Christodoulakis
- Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece
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Spiridakis KG, Intzepogazoglou DS, Flamourakis ME, Sfakianakis EE, Gkionis IG, Strataki KG, Tsagataki ES, Kostakis GE, Christodoulakis MS. Acute diverticulitis in patients under 50 years of age. G Chir 2018; 34:319-322. [PMID: 30444482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Acute diverticulitis typically occurs in patients over 80 years old. The last five years we observed an increased incidence of acute diverticulitis in patients under 50 years. The aim of this study is to evaluate the increased rate of patients under 50 years that are hospitalized due to acute diverticulitis. Also, we aim to confirm the common symptoms for this disease and the laboratory data, the changes in dietary history (Mediterranean diet) and lifestyle and to calculate the differences in the treatment and the severity in the course of the disease, between younger (<50) and older (>50) patients. PATIENTS AND METHODS From 2003 to 2008, 118 patients were admitted to our Surgical Department for acute diverticulitis. 32 patients were under 50 years old. In the next five year period (2008-2013) the number of patients under 50 that were admitted due to acute diverticulitis doubled to 183 with 102 patients being over 50 years and 61 patients under 50. For all these patients, the medical and dietary history, laboratory and clinical examinations, radiographic and endoscopic findings were recorded. RESULTS For patients aged over 50 years there is a predominance in male sex. Symptoms were the same in both groups and no difference in treatment was noted. Furthermore, readmission and recurrence rates were the same for both groups. The condition was equally aggressive in both groups. The only difference observed was increased obesity rate for patients under 50 and variation from the traditional Mediterranean diet to western diet habits. CONCLUSIONS Although our study has limitations it seems that new cases of diverticular disease in patients have increased due to dietary changes, but treatment and severity have remained the same.
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Spiridakis KG, Intzepogazoglou DS, Flamourakis ME, Sfakianakis EE, Daskalaki AV, Vakonaki EK, Rahmanis E, Kostakis GE, Christodoulakis MS. Necrotizing fasciitis associated with primary cutaneous B-cell lymphoma. A case report. G Chir 2017; 38:130-134. [PMID: 29205142 DOI: 10.11138/gchir/2017.38.3.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Necrotizing fasciitis is a rapidly progressive and life-threatening infection of the deeper skin layers and subcutaneous tissues that moves along the facial planes. OBJECTIVES We present the rare case of a patient with necrotizing fasciitis associated with high malignancy b-cell lymphoma. Our purpose is to investigate the probable connection between the two pathologies and evaluate the importance of early surgical intervention. CASE REPORT 51-year old Caucasian woman presented at the E.R. with history of a painful left thigh over a week and fever up to 38,4°C over the last three days. Necrosis of the soft tissues and fascial planes were observed clinically. After the initial treatment and due to the patient's multiple organ dysfunction (septic shock), she was transferred to the ICU were she was intubated resuscitated with IV fluids and given IV antibiotics. 24 hours after the admission it was decided that the patient should undergo surgery and an extensive debridement of the necrotic area was performed. The antibiogram of the blood culture revealed streptococcus pyogenes and she was administered penicillin while intubated and monitored in the ICU until the seventh postoperative day. On the eighth post-day she was transferred back to the surgical department, hemodynamically normal and stable. She was discharged one month later and she was referred to a plastic surgery center for the final reconstruction surgery. CONCLUSIONS This case highlights that the high index of suspicion and the early aggressive surgical intervention seems to be very critical to improve survival of the patients with necrotizing fasciitis.
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Spiridakis KG, Sfakianakis EE, Flamourakis ME, Intzepogazoglou DS, Tsagataki ES, Ximeris NE, Rachmanis EK, Gionis IG, Kostakis GE, Christodoulakis MS. Synchronous mucinous adenocarcinoma of the recto sigmoid revealed by and seeding an anal fistula. (A case report and review of the literature). Int J Surg Case Rep 2017. [PMID: 28641190 PMCID: PMC5479962 DOI: 10.1016/j.ijscr.2017.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The diagnosis of such conditions remains difficult when the colonic tumor is unknown and the chronic lesion of anal fistula seems to be a benign condition. The management of these cases remain controversial. The aim of this study highlights the importance of high suspicion with further investigation and the need of biopsy in all anal fistulas.
Introduction There are few cases of synchronous rectal adenocarcinoma revealed by an anal fistula. The diagnosis of synchronous mucinous adenocarcinoma of the recto sigmoid and anal canal remains difficult. The chronic anal fistula can be mistaken as the common manifestation of a benign perianal abscess or fistula. Case presentation We present a rare case of a Greek Caucasian 79 year old male patient with anal fistula and a recurrent perianal abscess who subsequently was found to have developed synchronous rectosigmoid and perianal mucinous adenocarcinoma on biopsy. The histological exam revealed mucinous adenocarcinoma in two sites, representing two tumors, cells were immunopositive for cytokeratin 20 and negative in cytokeratin 7. The patient underwent “laparoscopic extralevator abdominoperineal excision ” with both lesions being resected. There is no recurrence after four years of follow up. Conclusions This case highlights the importance of high suspicion, further investigation and the need of biopsy in all anal fistulae.
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Affiliation(s)
| | | | | | | | - Eleni S Tsagataki
- Venizeleio General Hospital, Department of Surgery, Heraklion, Crete, Greece.
| | - Nikolaos E Ximeris
- Venizeleio General Hospital, Department of Surgery, Heraklion, Crete, Greece.
| | | | - Ioannis G Gionis
- Venizeleio General Hospital, Department of Surgery, Heraklion, Crete, Greece.
| | - Giorgos E Kostakis
- Venizeleio General Hospital, Department of Surgery, Heraklion, Crete, Greece.
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Abstract
A 59-year-old man developed emphysematous cystitis 3 weeks after undergoing left orchiectomy because of suppurative epididymitis. The case is presented because of its unusual cause and to emphasize the high degree of suspicion required for the diagnosis.
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Affiliation(s)
- D D Tsiftsis
- Department of Surgical Oncology, Herakleion University Hospital, Crete, Greece
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