Traumatic fat necrosis of the breast

An instance of traumatic fat necrosis of the breast is reported and described, and the histological structure outlined. The importance of recognition of this lesion and of differentiating it from a carcinoma is stressed.     

Traumatic perforation of the sigmoid colon through schistosomal ulcerations

A case is presented in which the colon was perforated through a S. mansoni ulcer after blunt abdominal trauma. This is believed to be a unique situation. The colonic complications of schistosomiasis are discussed, and it is expected that they will be seen more frequently in the United States.     

Foreign body perforation of the sigmoid simulating carcinoma

A case history is presented of a patient in whom a swallowed fragment of toothpick perforated the sigmoid and entered a corpus luteum cyst of the left ovary. The prolonged symptomatology, anemia and x-ray evidence of an obstructive lesion led to a preoperative diagnosis of carcinoma of the sigmoid. At operation the perforated bowel and ovarian cyst were found involved in a hard yellow mass. Tissue from the mass revealed a unique reaction due to the response of the lutein cells to chronic irritation.     

Leiomyoma of the greater omentum presenting with massive ascites

INTRODUCTION: Primary tumours of the omentum are quite uncommon, although it is a common site for for secondaries.PRESENTATION OF CASE: We report a case of leiomyoma of the greater omentum in a 31-year-old nulliparous woman who presented with a 2-year history of progressive abdominal distension with examination findings of massive ascites and a mobile ill-defined centrally located intra-abdominal mass. The preoperative diagnosis was equivocal. At surgery a pedunculated greater omental mass, which was histologically reported as a leiomyoma, was seen. She had an uneventful post-operative recovery. She has been followed up for twelve months with no evidence of recurrence or residual disease.DISCUSSION: Extra-uterine leiomyoma is rare. It is even rarer for it to originate from the omentum. Pre-operative diagnosis is challenging. To the best of our knowledge this is the first reported case of leiomyoma of the omentum in Nigeria.CONCLUSION: The uncommon association of ascites with this tumour deserves further scrutiny. The patient is still being followed-up.     

Hartmann's procedure for carcinoma of the rectum and sigmoid colon.

A review of the Hartmann's operation for patients with rectal and sigmoid cancer over an 18 year period is presented. There were 1063 patients who had a resection for carcinoma of the rectum or sigmoid colon and 4.4% of these had a Hartmann's procedure. This operation was particularly useful in the management of patients who presented with a proximal obstruction or perforation at the tumour site. It was also effective in the elective treatment of elderly unfit patients who had locally advanced tumours or those with distant metastases. Re-anastomosis is recommended in those patients who are relatively fit and have had a potentially curative resection.     

Recurrence of sigmoid colon carcinoma in the residual urethra after cystectomy

INTRODUCTION: We report a case of recurrence of sigmoid colon cancer in the residual urethra after cysto-prostato-sigmoidectomy. METHODS/RESULTS: The patient successfully underwent urethrectomy and is currently tumor-free. To our knowledge, this is the first case of recurrence of a non-urothelial malignant tumor in the residual urethra.     

大网膜移植的应用解剖

目的 观测大网膜的形态及血管分布,探讨大网膜的设计剪裁,为临床提供可靠的解剖学资料。 方法 选用12例防腐固定处理的成人尸体,3例成人新鲜尸体。分别巨微解剖观测大网膜的形态及血管分布、进行明胶-氧化铅血管造影及三维重建。 结果 大网膜的长度为(24.7±6.9)cm,宽度为(28.3±2.8)cm,分为薄、中、厚三型,薄型占33.3％,中型占46.7％,厚型占20.0％。大网膜的血供来源于胃网膜左、右动脉沿胃大弯连接而构成胃网膜血管弓,从胃网膜血管弓向大网膜发出血管分支。大网膜的主要动脉有4条：①大网膜右动脉：起始处外径为（1.0±0.4）nm。②大网膜中动脉：起始处外径为(0.7±0.3)mm。③大网膜左动脉：起始处外径为(1.2±0.4)mm。④大网膜副动脉：起始处外径为(0.5±0.l)mm。 结论 根据大网膜前、后弓血管的解剖特点、大网膜中动脉分叉位置的高低及与延长方法,将大网膜分为5种不同的类型。在临床裁剪使用大网膜时,应根据5型的不同特点做不同的裁剪。     

Intraosseous fat necrosis simulating septic arthritis and osteomyelitis in a patient with chronic pancreatitis

A woman with a 20-year history of alcohol abuse and chronic pancreatitis developed an osteoarticular involvement of her right ankle in association with subcutaneous nodules. Histopathological examination of the tissue samples obtained during surgical revision of the ankle showed necrotic fat and connective tissue. Microbiological cultures remained negative. The patient was administered long-term antimicrobial treatment without any apparent benefit. Four months later, she died of pancreatic insufficiency and pneumonia. Postmortem examination showed numerous foci of intra-abdominal fat necrosis. Histopathological examination of the bone samples from the right ankle showed fat necrosis with lipophages. Based on these findings, we consider that the osteoarticular involvement in this patient was caused by intraosseous fat necrosis. This case reminds us of the importance of considering the possibility of this condition whenever a patient with chronic pancreatic disease develops sterile osteoarthritis. Received: 4 August 1997