Department of Surgery, Monmouth Medical Center, Long Branch, New Jersey (Drs. Mackowsky and Borao).
Department of Surgery, Hackensack University Medical Center, Hackensack, New Jersey (Drs. Hadjiloucas and Lira).

ABSTRACT

Background: Concurrent laparoscopic paraesophageal repair with colectomy has yet to be described in the literature.

Case Description: An 88-y-old male with shortness of breath and rectal bleeding presented to the emergency depart- ment. Workup ultimately revealed a nonobstructing ascending colon mass within the sac of type IV paraesophageal hernia. The decision was made to proceed with laparoscopic colectomy with concurrent paraesophageal hernia repair.

Conclusion: To reduce overall operative time and optimize recovery, the decision was made to perform both operations synchronously. The patient suffered no intraoperative or postoperative complications and experienced a full and timely recovery. To the best of our knowledge, simultaneous colon resection with paraesophageal hernia repair has not been described in the literature. Despite the inherent high risk, performing both procedures in a single operation helped to decrease the patient’s anesthesia time and overall recovery time as well as risks of reoperation.

Key Words: paraesophageal hernia repair, colectomy, adenocarcinoma.

The post Simultaneous Repair of Paraesophageal Hernia and Colectomy for Colon Cancer first appeared on JSLS.

ABSTRACT

Immune thrombocytopenic purpura and venous thromboembolism are rare but known complications of ulcerative colitis. Although several case studies have examined the treatment options available for ulcerative colitis patients presenting with immune thrombocytopenic purpura, there have been no reported cases that describe the optimal treatment for patients with ulcerative colitis and immune thrombocytopenic purpura complicated by simultaneous deep venous thromboses. We present the case of a 19-year-old woman who presented with ulcerative colitis and immune thrombocytopenic purpura and in whom multiple deep venous thromboses also developed. The patient underwent urgent simultaneous laparoscopic colectomy and splenectomy. She improved clinically, and her platelet count recovered after surgery. When thrombocytopenia develops in patients with ulcerative colitis, a diagnosis of immune thrombocytopenic purpura should be considered. In such patients, pre-existing ulcerative colitis might be involved in the immunologic causal mechanism of immune thrombocytopenic purpura and venous thromboembolism. In cases in which these entities are refractory to medical management or complicated by venous thromboembolism, simultaneous laparoscopic colectomy and splenectomy are safe and well tolerated and can be lifesaving.

The post Acute Ulcerative Colitis, Thrombocytopenia, and Venous Thromboembolism Treated With Combined Laparoscopic Splenectomy and Colectomy first appeared on JSLS.

Department of Surgery, Mercy Hospital and Medical Center, Chicago, IL, USA (all authors).

ABSTRACT

Background: Mesenteric venous thrombosis has been a reported rare postoperative complication after laparoscopic surgery and may lead to increased patient morbidity and possible mortality.

Methods: We report a case highlighting the postoperative presentation of mesenteric venous thrombosis after laparoscopic robotic-assisted colectomy and its management.

Results: We present a case of a 52-year-old woman who underwent robotic-assisted right colectomy after screening colonoscopy found an adenocarcinoma in the cecum. She was discharged on postoperative day 4 and returned to the emergency department on postoperative day 20 with diffuse abdominal pain and nausea/vomiting. A computed tomography scan showed thrombosis and complete occlusion of her superior mesenteric vein extending to the portal vein.

Conclusion: Mesenteric venous thrombosis is a rare but highly morbid postoperative complication after laparoscopic surgery. It should be considered in the differential diagnosis of delayed postoperative presentation with abdominal pain.

Key Words: Mesenteric venous thrombosis, Laparoscopic surgery, Colectomy, Robotic surgery.

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The post Mesenteric Venous Thrombosis After Laparoscopic Robotic-Assisted Colectomy first appeared on JSLS.