Carotid body tumor as a reversible cause of syncope

The causes of syncope are diverse and extensive; carotid body tumors are an extremely rare cause of syncope. These rare neoplasms represent less than 0.5% of all head and neck tumors. The authors present a case of a woman with syncope who was found to have a right-sided carotid body tumor. After surgical resection was performed, she did not have any additional syncopal or near-syncopal events. The authors provide a review of the literature on the natural history, presentation, and preferred management of carotid body tumors. With modern diagnostic tools and treatment options, most patients with this diagnosis can expect to recover fully.     

Periappendicular abscess as a cause of ureteral obstruction

Ureteral obstruction due to appendicitis is a rarity. A twenty-five year old man with no previous abdominal symptoms showed right-sided hydronephrosis and hydroureter on intravenous urography. At operation the cause for this was found to be a ureteral kink due to adhesions caused by a healed periappendicular abscess.     

Inverted papilloma as a cause of high-grade ureteral obstruction

Inverted papilloma of the urinary tract is a rare benign lesion. We report, to our knowledge, the first case of high-grade ureteral obstruction caused by an inverted papilloma with coexistent carcinomatous elements. Our patient was referred for evaluation of painless, gross hematuria. Imaging studies demonstrated a left proximal ureteral filling defect causing severe left-sided hydroureteronephrosis. Ureteroscopy demonstrated a 1-cm papillary lesion on the medial aspect of the proximal ureteral wall. Pathologic examination documented a lesion with elements of inverted papilloma and a small focus of well-differentiated transitional cell carcinoma. We discuss the management and significance of this rare urothelial lesion.     

Cecal volvulus as a rare cause of intestinal obstruction

Caecal volvulus is very rare causa of the intestinal obstruction. It ocures in 1- 1,5% of all intestinal obstructions. It is known that there is only on treatment in this situation which is surgery. It is classified as an obstruction because of strangulation.We present a case of the 46 year old patient, who was operated because of intestinal obstruction. During the operation caecal volvulus has been found, with gangrene of the appendices.     

Bezoars as a cause for acute small intestinal obstruction

Results of treatment of 12 patients with acute small intestinal obstruction due to bezoars were analyzed. Mean age of the patients was 67,5+/-3,7 years. In 9 of them bezoars were localized in the ileum, in 3 -- in the jejunum. Mechanisms of bezoars formation are analyzed. Clinical symptoms of intestinal obstruction due to bezoars are regarded. Necessity of surgical treatment of these patients is noted. Bezoars were removed with enterotomy in 10 patients, in 2 -- with fragmentation and transposition in the cecum. Recommendations on surgical techniques are presented. All operated patients have recovered. There were no complications.     

Endometriosis of sigmoid as a cause of acute intestinal obstruction

Endometriosis of the bowel is of sufficiently frequent occurrence to warrant emphasis of the characteristic symptoms by review of a case in which the correct preoperative diagnosis was made, but only after acute obstruction had supervened.     

Ectopic pancreas as a cause of jejunal obstruction in a neonate

This report describes a case of symptomatic ectopic pancreas in the jejunum. A review of the literature revealed no other case of ectopic pancreas manifesting as jejunal stenosis during the neonatal period. Ectopic pancreas should be excised in consideration of the potential late complications.     

Multiple system atrophy as a cause of upper airway obstruction

A patient presented to the ear, nose and throat department with inspiratory stridor, dysphagia and a sore throat. Clinical and radiological examination was normal. During induction of anaesthesia for a planned microlaryngoscopy, the patient developed complete upper airway obstruction that was overcome by applying positive pressure via a facepiece until awake. He subsequently developed respiratory failure, requiring mechanical ventilatory support. An elective tracheostomy was inserted for his symptoms. Neurological opinion confirmed the diagnosis of multiple system atrophy with akinetic rigid syndrome. We review this obscure condition and how it may occasionally present to anaesthetists.