Removal of a guide-wire sliding into abdominal cavity via transgastric natural orifice transluminal endoscopic surgery: A case report

BACKGROUND Guidewire slippage into the peritoneal cavity during clinical operations is extremely rare.Therefore,this paper aims to report a successful case of guidewire removal using transgastric natural orifice transluminal endoscopic surgery(NOTES).The goal is to enhance physicians'understanding of the management plan for this unique scenario and provide a valuable reference for clinical practice.CASE SUMMARY A 64-year-old man presented with abdominal distension and was diagnosed with cirrhosis combined with massive ascites.To proceed with treatment,the patient underwent ultrasound-guided peritoneal puncture and underwent catheterization and drainage.Unfortunately,a 0.035-inch guidewire slipped into the abdominal cavity during the procedure.Following a comprehensive evaluation and consultation by a multidisciplinary team,the guidewire was successfully removed using NOTES.CONCLUSION This case highlights the potential consideration of transgastric NOTES removal when encountering a foreign body,such as a guidewire,within the abdominal cavity.

Primary intra-abdominal paraganglioma:A case report

BACKGROUND Paragangliomas are rare neuroendocrine tumors.We hereby report a case of a localized paraganglioma found in the abdominal cavity,and review the relevant literature to improve the understanding of this disease.CASE SUMMARY A 29-year-old Chinese female patient was referred to our hospital due to an abdominal mass found on physical examination.Imaging revealed a mass in the left upper abdomen,suggestive of either a benign stromal tumor or an ectopic accessory spleen.Laparoscopic radical resection was subsequently performed,and histopathological analysis confirmed the diagnosis of a paraganglioma.The patient was followed up 3 months post-operation,and reported good recovery with no metastasis.CONCLUSION Radical resection can effectively treat intra-abdominal paragangliomas,with few side effects and low recurrence risk.In addition,early and accurate diagnosis and timely intervention are essential for the prognosis of this disease.

Abdominal bronchogenic cyst:A rare case report

BACKGROUND Bronchogenic cysts are cystic masses caused by congenital abnormal development of the respiratory system,and usually occur in the pulmonary parenchyma or mediastinum.CASE SUMMARY A rare case of a bronchogenic cyst discovered in the abdominal cavity of a 35-year-old man is reported.Physical examination found a space-occupying lesion in the patient’s abdomen for 4 d.Laparoscopic exploration found the cyst tightly adhered to the stomach and its peripheral blood vessels;therefore,intraoperative laparotomy was performed.The cystic mass was resected en bloc with an Endo-GIA stapler.The final postoperative pathological diagnosis confirmed an abdominal bronchogenic cyst.CONCLUSION This is a rare case of a bronchogenic cyst that was discovered within the abdominal cavity of a male patient.The cyst is easily confused with or misdiagnosed as other lesions.Therefore,it is necessary to distinguish abdominal bronchogenic cyst from gastrointestinal stromal tumor,Meckel’s diverticulum,enteric duplication cyst,or lymphangioma.Although computer tomography and magnetic resonance imaging were the primary diagnostic approaches,endoscopic ultrasound-guided fine-needle aspiration could assist with clarification of the cytological or histopathological diagnosis before surgery.

Extragastrointestinal stromal tumors with diffuse membranous distribution with bleeding:A case report

BACKGROUND Extragastrointestinal stromal tumors(EGIST)and gastrointestinal stromal tumors are of similar pathological type and form.Here we report a rare case of EGIST diffusely distributed in membranous tissue in abdominal cavity,the feature of which included diffuse tumors at membranous tissue in entire abdominal cavity and spontaneous bleeding of the tumors.CASE SUMMARY The patient was a 71-year man and hospitalized due to continuous pain at lower abdomen for more than 10 days.Upon physical examination,the patient had flat and tough abdomen with mild pressing pain at lower abdomen,no obvious abdominal mass was touchable,and shifting dullness was positive.Positron emission tomography-computed tomography(CT)showed that in his peritoneal cavity,there were multiple nodules of various sizes,seroperitoneum,multiple enlarged lymph nodes in abdominal/pelvic cavity and right external ilium as well as pulmonary nodules.Plain CT scanning at epigastrium/hypogastrium/pelvic cavity+enhanced three-dimensional reconstruction revealed multiple soft tissue nodules in abdominal/pelvic cavity,peritoneum and right groin.Tumor marker of carbohydrate antigen 125 was 808 U/mL,diffuse tuberous tumor was seen in abdominal/pelvic cavity during operation with hematocelia,and postoperative pathological examination confirmed EGIST.Imatinib was administered with better therapeutic effect.CONCLUSION Gene testing showed breast cancer susceptibility gene 1 interacting protein C-terminal helicase 1 and KIT genovariation,and the patient was treated with imatinib follow-up visit found that his clinical symptoms disappeared and the tumor load alleviated obviously via imageological examination.

Correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine in colorectal cancer patients

Objective To explore the correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine(CM)in colorectal cancer patients.Methods Totally 112 colorectal cancer patients undergoing open abdominal surgery or laporoscopic surgery were syndrome typed as five fypes,i.e.,inner-accumulation of damp and heat,blockage of