High-grade small bowel angiosarcoma associated with angiosarcomatosis: a case report

Angiosarcoma is a rare soft-tissue neoplasm occurring most often in the skin and the subcutaneous tissues and very rarely in the gastrointestinal tract. We report a case of a 25-year-old woman who presented with a small intestinal angiosarcoma associated with angiosarcomatosis. The diagnosis was established on surgical intestinal resection, that showed a high-grade angiosarcoma with epithelioid component and foci of agressive form of hemangioendothelioma. Immunohistochemical study revealed tumour cell positivity with endothelial markers CD31 and factor VIII whereas CD34 and epithelial markers were negative. The tumour displayed KIT (CD117) immunoreactivity without KIT or PDGFRA mutation on molecular analysis. Clinical and pathological features as well as differential diagnosis of this rare entity in gastrointestinal tract are discussed.     

Schistosoma mekongi infection in a leiomyosarcoma of the small bowel: a case report.

We report a fortuitous occurrence of a small bowel leiomyosarcoma infected with Schistosoma mekongi in an elderly patient from Kampuchea. S mekongi is endemic in countries along the lower Mekong River basin (Laos, Thailand, and Kampuchea), where its intermediate snail hosts (Lithoglyphopsis aperta) are found. The diagnosis was made by examining the numerous ova that were embedded in the tumor and along the small bowel wall. The ova with their small lateral spines are easily confused with those of Schistosoma japonicum, but are consistently smaller and round. The patient presented with lower gastrointestinal bleeding secondary to tumor invasion of the small bowel rather than from heavy parasitic infection. Because of the spindle-cell morphology of the tumor, an exuberant fibroblastic host reaction to the ova was considered during frozen section examination. Unlike the more common species of schistosoma (eg, Schistosoma mansoni and Schistosoma haematobium) that are associated with the development of malignant neoplasms, we believe our case represents a chance finding and that the possible role of S mekongi infection in the neoplastic process is unlikely.     

Squamous cell carcinoma of the small bowel manifesting as a jejunal perforation: a case report

Squamous cell carcinoma arising from the small intestine is rare and difficult to identify as a primary or metastatic feature. We report a case of small intestinal squamous cell carcinoma manifesting as subacute peritonitis due to perforation. An 80-year-old man was admitted to our hospital with intermittent postprandial abdominal pain. He was diagnosed with acute peritonitis due to gastrointestinal perforation. During explorative laparotomy, a perforation site was detected in the jejunum and segmental resection to correct the perforation was performed including the perforation site located at the 70 cm inside the jejunum from the Treitz ligament. The pathology results revealed squamous cell carcinoma in the resected segment of the jejunum with two perforation sites.     

Jejunal angiomatoses causing small bowel obstruction in a patient with Down syndrome: a case report

Gastrointestinal vascular anomalies are extremely uncommon. We describe a patient with Down syndrome who presented with acute abdominal pain due to a mixed capillary and venous vascular malformation involving the proximal jejunum.     

Solitary fibrous tumor of small bowel mesentery with postoperative bowel obstruction: a case report and review of literature

Solitary fibrous tumor (SFT) which is an extremely rare clinical entity has been reported infrequently. Most commonly it is distinguished into pleural and extrapleural forms, with same morphological resemblance. There has been many literatures reported regarding extrapleural form of SFT but few cases of SFT originating from small bowel mesentery have been reported till now. We here report one case of SFT of small bowel mesentery with some eventful postoperative bowel obstruction and literature review.     

Polypoid gastrointestinal stromal tumor of small bowel metastasizing to mesenteric lymph nodes: a case report

Gastrointestinal stromal tumor (GIST) is the commonest gastrointestinal mesenchymal tumor, which rarely metastasizes to lymph nodes. Therefore, unlike cases of adenocarcinoma, lymphadenectomy is seldom warranted. We describe an unusual case of a polypoid GIST of the small bowel which metastasized to the regional mesenteric lymph nodes at the time of primary surgery. The patient was a 79-year-old female who presented with partial bowel obstruction and anemia. The presented case has three unusual features, as the tumor was grossly pedunculated, microscopically pleomorphic, and featured mesenteric lymph node metastasis at the time of diagnosis.     

Massive small bowel infarction and duodenal perforation due to abdominal polyarteritis nodosa: a case report

A 37-year-old Chinese male presented with an acute abdomen. Surgical exploration revealed duodenal perforation, extensive small bowel infarction and peritonitis. Histopathology of the resected bowel showed characteristic features of classic polyarteritis nodosa. The latter also involved mesenteric arteries in the form of tiny aneurysms. Steroids could not be started due to: (i) overwhelming microbial infections and (ii) fear of more perforations in other areas of the bowel. Such a presentation of polyarteritis nodosa is uncommon. Its recognition prior to surgery, management and prognosis is discussed.     

Spontaneous aortocaval fistula: a case report and literature review

Spontaneous aortocaval fistula is a rare complication of abdominal aortic aneurysms. We describe two cases of spontaneous aortocaval fistula. The first patient is a woman who was admitted with abdominal pain and pulsatile abdominal mass. Another patient was a man admitted with progressive abdominal pain and hypotension. Computed tomography (CT) scan in both patients showed an infrarenal aortic aneurysm and simultaneous contrast enhancement in the inferior vena cava. Both patients underwent an urgent laparotomy in which the diagnosis of an aortocaval fistula was confirmed. We review the literature on spontaneous aortocaval fistula as a consequenceof complicated aortic aneurysms.     

Rupture of the rectosigmoid colon with evisceration of the small bowel through the anus

Spontaneous rupture of the rectosigmoid colon and herniation of the small intestine through the rupture site and eventual evisceration through the anus is a very rare event. In the literature, only 42 cases have been reported. The majority of them occurred in patients with rectal prolapse and one case was reported in association with a third-degree uterine prolapse. We experienced an 81-year-old female patient with rectal prolapse and second-degree uterine prolapse complicated by spontaneous perforation of the rectosigmoid colon and anal evisceration of the small intestine. Segmental resection of the nonviable small intestine, primary repair of the ruptured rectosigmoid colon, and sigmoid loop colostomy were performed, and the patient recovered well. In our patient, both rectal and uterine prolapses cooperatively damaged the anterior wall of the rectosigmoid colon and resulted in perforation. So, rectal and uterine prolapses should be treated before the complication develops. In this patient, uterine prolapse should be treated because of the recurrence of this rare episode.     

Spontaneous uterine rupture in the first trimester: a case report

Uterine rupture is one of the most feared obstetric complications affecting the pregnant woman and fetus. Most of the cases have various risk factors and mainly occur during the second or third trimester. However, spontaneous uterine rupture during the first trimester is extremely rare. We experienced a case of spontaneous uterine rupture in a 36-yr-old multiparous woman without definite risk factors. The initial impression was a hemoperitoneum of an unknown origin with normal early pregnancy. Intensive surgical method would be needed for accurate diagnosis and immediate management in bad situation by hemoperitoneum even though a patient was early pregnancy.     

Spontaneous bacterial peritonitis due to Ochrobactrum anthropi: a case report

We report a case of spontaneous bacterial peritonitis from Ochrobactrum anthropi. O. anthropi is recognized as an emerging pathogen in immunocompromised patients. In contrast to most previously described cases, the patient reported here had no indwelling catheter. To our knowledge, no case of O. anthropi spontaneous bacterial peritonitis has been reported in the medical literature until now.     

宫颈小细胞癌一例

患者女,39岁.因阴道血性分泌物增多及同房后阴道出血6个多月于2007年8月来本院行宫颈液基脱落细胞学(TCT)检查.     

含小神经元成分的神经节胶质瘤一例

患者男,24岁。因不明原因抽搐2d于2006年12月7日入本院神经外科接受治疗。心肺功能正常。影像学榆查：头CT示右侧基底节区可见囊实性混杂密度肿块影,囊性部分未见强化,实性部分呈环状不均匀强化,右侧脑室受压轻度左移。头部磁共振血管成像（MRI）示右大脑中动脉略前移位。诊断意见：右基底节区占位性病变,星形细胞瘤可能性大。行右基底节区肿瘤切除术后1个月,头CT检查结果显示右侧脑室受压不明显,临床症状基本消失。[第一段]     

Uro-retroperitoneum after ultrasound-guided transvaginal follicle puncture in an oocyte donor: a case report

Ultrasound-guided transvaginal follicle aspiration is the standard technique for oocyte retrieval prior to IVF. Complications are rare, but some are potentially serious. We report a case of ureteral injury with acute-onset uro-retroperitoneum in a volunteer oocyte donor. The patient recovered rapidly after ureteral stenting. This case underlines the need for all candidate oocyte donors to receive proper information on serious procedure-related complications.     

Spontaneous rupture of hepatic hemangioma: a case report and literature review

Hepatic hemangioma, a common benign tumor of the liver, has caused great threats to the public health. Most patients have an excellent prognosis because of the benign nature of hemangioma. On some occasions, spontaneous rupture of hepatic hemangioma is rarely observed in patients. Therefore, a majority of scholars propose that surgery should be restricted to specific situations. In this case, we presented a patient with spontaneous rupture of hepatic hemangioma in our hospital. After a literature review, we summarized the management and outcome of the patient, which revealed the survival rates of the patients are satisfactory.