Abstract: OBJECTIVE: We report a case of primary hypertrophic pyloric stenosis combined with a paraduodenal hernia in a 35-year-old woman. CLINICAL PRESENTATION AND INTERVENTION: The patient presented with signs of obstructive ileus. CT of the abdomen revealed a marked dilatation of the stomach and the proximal jejunum as well as a circumferential thickening of the antral-pyloric region with characteristics indicating hypertrophic pyloric stenosis. Exploratory laparotomy revealed the presence of a paraduodenal hernia containing jejunal loops and marked thickening of the pyloric region. The jejunum was reduced to its normal place and the ostium of the paraduodenal hernia closed with a running suture. The hypertrophic pyloric stenosis was treated with pyloromyotomy. Since the patient had no predisposing factors for the development of secondary pyloric stenosis, we considered the pyloric stenosis as congenital in origin. CONCLUSION: To our knowledge this is the first reported case of congenital pyloric stenosis combined with the presence of a paraduodenal hernia in an adult.
Abstract: A 36-year-old man was admitted with a 3-day history of severe abdominal pain in the right upper abdomen and was initially diagnosed with acute cholecystitis or acute retrocecal appendicitis. The patient was transferred to the department of surgery for close surgical observation. CT of the entire abdomen was performed just before the operation, which demonstrated inflammation in the omental fat. Surgery revealed primary omental torsion and subsequent resection of the infarcted segment offered a rapid recovery. We report a case of primary segmental omental torsion and discuss the diagnostic and therapeutic implications of this unusual entity.
Abstract: Pseudocysts of the adrenal gland are rare lesions, which are usually discovered as incidental findings. Since they are in the majority of cases non-functioning, they become symptomatic only when they are complicated with rupture, haemorrhage or infection. We present a case of a 28-year-old woman in the 26th gestational week, who developed an acute abdomen due to a haemorrhagic pseudocyst of the left adrenal. The patient was submitted to left adrenalectomy. The described case is the third reported case of cystic adrenal lesion discovered during pregnancy and only the first reported case of acute presentation of an adrenal pseudocyst during pregnancy.
