This case report describes a woman with spontaneous rectal perforation from decidualized endometriosis in pregnancy.A 37-year-old woman was admitted to our hospital at 30 wk of pregnancy with symptoms suggestive of py...This case report describes a woman with spontaneous rectal perforation from decidualized endometriosis in pregnancy.A 37-year-old woman was admitted to our hospital at 30 wk of pregnancy with symptoms suggestive of pyelonephritis,which persisted until 33 wk of gestation when delivery of a premature male baby was performed through a cesarean section. On postoperative day 2,an abdominal computed tomography showed free air in the peritoneal cavity and a pelvic abscess.Explorative celiotomy revealed a diffuse severe fecaloid peritonitis that originated from a 3-cm wide rectal perforation.A Hartmann operation was then performed.Histopathological findings wereconsistent with decidualization of the rectal wall.Only 20 cases of intestinal perforation due to endometriosis have been reported in the literature.This report is believed to be the first case of spontaneous rectal perforation from endometriosis in pregnancy,and it shows the potential occurrence of serious and unexpected complications of the disease.展开更多
This study aimed to describe a case in which an isolated splenic metastasis was synchronous with the colonic primary and a concomitant splenic abscess was associated. A wide review of the literature was also performed...This study aimed to describe a case in which an isolated splenic metastasis was synchronous with the colonic primary and a concomitant splenic abscess was associated. A wide review of the literature was also performed. A 54-year-old woman with abdominal pain and fever was admitted to our department. Abdominal CT revealed two low-density areas in the spleen and wall-thickening of the left colonic flexure,which was indistinguishable from the spleen parenchyma. The patient underwent emergency celiotomy,with the presumptive diagnosis of obstructing colon carcinoma of the splenic flexure,and concomitant splenic abscess. Subtotal colectomy and splenectomy were performed. Pathological findings were consistent with mucinous colonic carcinoma,synchronous isolated splenic metastasis and concomitant splenic abscess. This paper is also a review of the existing literature on the association between colorectal cancer and splenic metastasis. Only 41 cases of isolated splenic metastasis from colon carcinoma have been reported in the literature. This report is the third described case of synchronous isolated splenic metastasis from colon carcinoma. Only one case with concomitant splenic abscess has been previously reported. When obstructing left-sided colorectal cancer is suspected,careful CT examination can allow early diagnosis of splenic involvement by the tumor. The literature review suggests that there might be a significant improvement in survival following splenectomy for a metachronous isolated splenic metastasis from colon carcinoma. Prognosis for synchronous splenic metastasis seems to be related to the advanced stage of the disease. Nevertheless,no definitive conclusions can be drawn because of the small number of cases.展开更多
基金Supported by A grant from the University of Cagliari,Italy
文摘This case report describes a woman with spontaneous rectal perforation from decidualized endometriosis in pregnancy.A 37-year-old woman was admitted to our hospital at 30 wk of pregnancy with symptoms suggestive of pyelonephritis,which persisted until 33 wk of gestation when delivery of a premature male baby was performed through a cesarean section. On postoperative day 2,an abdominal computed tomography showed free air in the peritoneal cavity and a pelvic abscess.Explorative celiotomy revealed a diffuse severe fecaloid peritonitis that originated from a 3-cm wide rectal perforation.A Hartmann operation was then performed.Histopathological findings wereconsistent with decidualization of the rectal wall.Only 20 cases of intestinal perforation due to endometriosis have been reported in the literature.This report is believed to be the first case of spontaneous rectal perforation from endometriosis in pregnancy,and it shows the potential occurrence of serious and unexpected complications of the disease.
基金Supported by grant from the University of Cagliari, Italy
文摘This study aimed to describe a case in which an isolated splenic metastasis was synchronous with the colonic primary and a concomitant splenic abscess was associated. A wide review of the literature was also performed. A 54-year-old woman with abdominal pain and fever was admitted to our department. Abdominal CT revealed two low-density areas in the spleen and wall-thickening of the left colonic flexure,which was indistinguishable from the spleen parenchyma. The patient underwent emergency celiotomy,with the presumptive diagnosis of obstructing colon carcinoma of the splenic flexure,and concomitant splenic abscess. Subtotal colectomy and splenectomy were performed. Pathological findings were consistent with mucinous colonic carcinoma,synchronous isolated splenic metastasis and concomitant splenic abscess. This paper is also a review of the existing literature on the association between colorectal cancer and splenic metastasis. Only 41 cases of isolated splenic metastasis from colon carcinoma have been reported in the literature. This report is the third described case of synchronous isolated splenic metastasis from colon carcinoma. Only one case with concomitant splenic abscess has been previously reported. When obstructing left-sided colorectal cancer is suspected,careful CT examination can allow early diagnosis of splenic involvement by the tumor. The literature review suggests that there might be a significant improvement in survival following splenectomy for a metachronous isolated splenic metastasis from colon carcinoma. Prognosis for synchronous splenic metastasis seems to be related to the advanced stage of the disease. Nevertheless,no definitive conclusions can be drawn because of the small number of cases.
