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Rethinking Right Upper Quadrant (RUQ) Pain: The Role of Lemmel Syndrome in Biliary Obstruction.
Cureus
December 2024
Gastroenterology and Hepatology, Monmouth Medical Center, Long Branch, USA.
Lemmel syndrome involves a periampullary duodenal diverticulum (PAD), a pouch-like outpouching near the ampulla of Vater, compressing the common bile duct. We describe a case of severe abdominal pain in a patient who had a large periampullary diverticulum, managed with surgical intervention after an initial failed endoscopic retrograde cholangiopancreatography (ERCP). An elderly female patient in her early 90s arrived at the emergency department with severe cramping pain localized to the right upper quadrant of her abdomen, progressively intensifying over several weeks.
View Article and Find Full Text PDFSuccessful Endoscopic Retrograde Cholangiopancreatography for Management of Choledocholithiasis in a Patient With Situs Inversus Totalis: A Case Report and Literature Review.
Gastro Hep Adv
September 2024
Gastroenterology Division, Medicine Department, Prince Mohammed Bin Abdulaziz Hospital, Ministry National Guard - Health Affairs, Almadinah, Almunawwarah, KSA.
Situs inversus totalis is a rare congenital disorder defined by the transposition of all viscera to the opposite side of the body. Because of this anatomical alteration, endoscopic retrograde cholangiopancreatography (ERCP) in such a population is significantly challenging. Herein we report a case of a 50-year-old woman presented with epigastric and left upper quadrant pain.
View Article and Find Full Text PDFJejunal Artery Aneurysm Exclusion With Immediate Vascular Reconstruction: A Case Report.
Port J Card Thorac Vasc Surg
January 2025
Angiology and Vascular Surgery, Unidade Local de Saúde de São João; Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal.
A 44 year-old previously healthy woman presented a persistent epigastric pain. Computed tomography revealed a saccular aneurysm with a diameter of 25x20 mm in the first jejunal artery and also a stenosis in the celiac trunk associated with median arcuate ligament syndrome, turning the hepatic perfusion dependent of the gastroduodenal artery flow. Through a midline laparotomy, celiac axis was exposed, and median arcuate ligament released for median arcuate ligament syndrome treatment.
View Article and Find Full Text PDFPrepancreatic postduodenal portal vein discovered in a pediatric patient undergoing total pancreatectomy with islet autotransplantation: a case report and review of literature.
Front Surg
January 2025
Department of Abdominal Transplant and Hepatopancreatobiliary Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
Background: Prepancreatic postduodenal portal vein (PPPV) is a rare anatomic variant where the portal vein (PV) runs anterior to the pancreas and posterior to the duodenum. Only 20 cases of PPPV, all in adults, have been reported in literature. We report the first case of PPPV in a pediatric patient discovered intraoperatively during total pancreatectomy with islet autotransplantation (TPIAT) and the third known case in which the PPPV could be isolated intraoperatively.
View Article and Find Full Text PDFAspergillus Species as a Rare Cause of Primary Mycotic Aneurysm With Aortoenteric Fistula.
Cureus
December 2024
Vascular Surgery, King Saud Medical City, Riyadh, SAU.
Aortoenteric fistula (AEF) is an abnormal connection between the aorta and the adjacent gastrointestinal (GI) tract and is often misdiagnosed in clinical practice. We present the case of a 65-year-old male, who presented with upper GI bleeding and melena. The patient underwent upper and lower GI examinations with no conclusive findings.
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