Retroperitoneal parasitic fetus: A case report

BACKGROUND Fetus-in-fetu(FIF)is an extremely rare congenital abnormal mass,in which a normal fetus’s vertebral axis frequently connected with malformed fetus around this axis.Here,we report the case of a male infant aged 26 d presenting with retroperitoneal parasitic fetus.CASE SUMMARY In a prenatal examination,we first detected an abdominal mass measuring 7.8 cm×5.1 cm×6.8 cm in a mother’s abdomen at 25 gestational weeks and teratoma was suspected.After the fetal was born,we did a magnetic resonance imaging(MRI)and ultrasonography on him and saw a distinctive limb with five-toes.According to the result of MRI,ultrasonography and postoperative pathology,he finally was diagnosed with FIF.CONCLUSION A laparotomy was performed at 26 d of age with excision of the retroperitoneal cystic tumor,which measured about 10 cm in diameter.According to the result of imaging and histological test,FIF was confirmed.

Tuberculous peritonitis complicated by an intraperitoneal tuberculous abscess: A case report

BACKGROUND Tuberculous peritonitis(TBP)is a chronic,diffuse inflammation of the peritoneum caused by Mycobacterium tuberculosis.The route of infection can be by direct spread of intraperitoneal tuberculosis(TB)or by hematogenous dissemination.The former is more common,such as intestinal TB,mesenteric lymphatic TB,fa-llopian tube TB,etc.,and can be the direct primary lesion of the disease.CASE SUMMARY We present an older male patient with TBP complicated by an abdominal mass.The patient's preoperative symptoms,signs and imaging data suggested a poss-ible abdominal tumor.After surgical treatment,the patient's primary diagnosis of TBP complicating an intraperitoneal tuberculous abscess was established by com-bining past medical history,postoperative pathology,and positive results of TB-related laboratory tests.The patient's symptoms were significantly reduced after surgical treatment,and he was discharged from the hospital with instructions to continue treatment at a TB specialist hospital and to undergo anti-TB treatment if necessary.CONCLUSION This case report analyses the management of TBP complicated by intraperitoneal tuberculous abscess and highlights the importance of early definitive diagnosis in the hope of improving the clinical management of this type of disease.

Unusual clinical presentation of primary aortoduodenal fistula

Primary aorto-enteric fistula(PAEF)develops between the native aorta and the gastro-intestinal tract,in the presence of an abdominal aortic aneurysm.It is a rare,life-threatening condition and appears to be less frequent than secondary aortoenteric fistula,which is associated with previous aortic prosthetic reconstruction.When untreated,the overall mortality rate is almost 100%.Diagnosis may be challenging until the occurrence of a massive haemorrhage.In the presence of gross contamination,patients tend to a worse prognosis.Extra-anatomical bypass and repair of the enteric tract is the treatment of choice in case of gross contamination.In situ reconstruction is often reported in cases of mild bacterial contamination.Endovascular treatment has recently become a valid option in haemodynamically unstable patients,but a staged approach,with delayed surgical treatment,seems advisable.