Right Side Of Abdomen Research Articles

Multilocular Cystic Renal Neoplasm of Low Malignant Potential - A Rare Case Report with Literature Review

Multilocular cystic renal cell carcinoma or multilocular clear cell renal cell carcinoma is a rare type of cystic neoplasms of kidney. MCRCC comprises 1-2% of all renal tumors. MCRCC has well defined diagnostic criteria, has low stage The term MCRCC was renamed as MCRNLMP by ISUP in 2013.Only few cases of MCRCC are reported in literature till now We report a rare case of MCRCC / MCRNLMP in 52 years female presented with chief complaints of pain and dragging sensation in the right side of abdomen for 1 year. Keywords: Multilocular, cystic, renal cell carcinoma, nephrectomy, low malignant potential

CASE REPORT ON RARE OUTCOME OF A RETROPERITONEAL MASS: MANAGEMENT CHALLENGES AND LESSONS LEARNT

Background. Gastrointestinal stromal tumours (GIST) are non-epithelial mesenchymal solid neoplasm with varied presentation. The study reports the case of a retroperitoneal GIST in a 21‑year‑old male presented with an abdominal lump for six months. The lesion was initially thought to be a retroperitoneal sarcoma. Exploratory laparotomy revealed an abdominopelvic mass covering the entire right side of abdomen and pelvis. The tumour was adherent to the terminal ileum and ascending colon. There were dense adhesions between the retroperitoneum with involvement of the middle third of the right ureter. The tumour was resected with right hemicolectomy with ileotransverse anastomosis. Post-operative histopathology revealed it as high-grade spindle cell type GIST. The patient is presently on post-operative chemotherapy with Imatinib mesylate. Objective. Atypical presentations of GIST are seldom discussed but frequently encountered in clinical practice. This article depicts different challenges the surgeon has to face while diagnosing such atypical entity. Methods. Case report of atypical GIST presenting as retroperitoneal lump. Results. The patient underwent surgical resection and is presently on post-operative chemotherapy with good overall outcome for a one year follow up. Conclusions. GISTs presenting as retroperitoneal lumps are very rare, they should be considered in their differential diagnosis of an atypical retroperitoneal mass.

P-096: ACUTE SICKLE CELL INTRAHEPATIC CHOLESTASIS: RARE DISEASE WITH UNUSUAL PRESENTATION, LESSONS LEARNT FROM AN INTERESTING CASE.

Purpose: Management of Sickle cell disease in India the is evolving. The pediatric fatal disease is shifting to adult chronic organ disease. Sickle hepatopathy is an umbrella term which covers hepatic sickle crisis, acute hepatic sequestration crisis although uncommon but manageable. Acute sickle cell intrahepatic cholestasis (SCIC) is a rare phenomenon, difficult to treat and has very high mortality. The pathogenesis of Acute sickle cell intrahepatic cholestasis involves sickling within the hepatic sinusoids leading to vascular stasis, hypoxia, and ballooning of the hepatocytes, resulting in intracanalicular cholestasis. We describe a difficult case of Acute sickle cell intrahepatic cholestasis which has a subacute course, challenges faced, and lessons learnt from managing it. Materials and methods: A 14-year-old girl with sickle cell anemia who was non-compliant with hydroxyurea treatment presented to us with complaints of pain in the right side of abdomen, drowsiness, lethargy, nausea and loss of appetite. She was transfused twice at another center before reaching our center. On examination, she was disoriented, febrile, icteric, severely pale with active bleeding from gums and mouth and moderate hepatosplenomegaly. Hemoglobin was 7.2 grams/ dl with reticulocyte count of 2%, with neutrophilic leukocytosis and normal platelet count. Hemoglobin S was 42%. Serum bilirubin was 68 mg/dl with direct fraction of 65.3mg/dl. SGPT and SGOT were 263 and 202 IU/dl respectively and prothrombin time was raised with INR of 1.79. Viral hepatitis A, B, C and E were ruled out. Bacterial infections were ruled out. The possibility of Acute sickle cell intrahepatic cholestasis was considered, and the child was managed with partial exchange transfusion till Hemoglobin S was brought to <10%. She also received fresh frozen plasma in view of raised prothrombin time and active bleeding. Results: She did not improve until 14 days after admission.Gradually after 20 days she started talking and eating. However, liver enzymes and bilirubin normalized only after 40 days. She was discharged in stable condition and is continued on follow up. Conclusion: Sickle cell hepatopathy is an umbrella diagnosis for all the varied causes of hepatic dysfunction ranging from sickling crisis to transfusion transmitted viral infections. In our case, viral hepatitis was ruled out conclusively.A very rare condition Acute sickle cell intrahepatic cholestasis was considered in view of the clinical presentation serum bilirubin was extremely high and mildly elevated transaminases. However. Hepatic sequestration was unlikely based on the hemoglobin level and reticulocyte count. Differentiating the varied causes in resource constrained centers can be often a daunting task and multipronged management needs to be initiated at the earliest to ensure a positive outcome. The authors do not declare any conflict of interest

Primary synovial sarcoma of kidney: a rare case report with review of literature

BackgroundSynovial sarcoma is a rare type of sarcoma with a predilection for extremities in young adults. Very rarely this tumor can originate from kidney.Case presentationA 22-year-old female presented to us with complaints of right flank pain and a large mass in the right side of abdomen for the last 6 months. A provisional diagnosis of renal cell carcinoma was made and right radical nephrectomy was done. However on histopathological examination the tumor was composed of spindle cells arranged in hemangiopericytoma-like vascular pattern. Immunohistochemistry and FISH confirmed the diagnosis of synovial sarcoma of kidney. The patient had no signs of recurrence or metastasis at six months of follow-up.ConclusionRenal synovial sarcomas, though rare, should be considered as a differential in young adults who present with extremely large renal mass. Surgical extirpation is the treatment of choice. Ifosfamide- and doxorubicin-based chemotherapy can be given in non resectable and metastatic cases.

A HIV-positive subject with dermatomal and generalized vesicular skin lesions

A 58-year old man with HIV infection diagnosed in 2018 presented in July 2021 with a 7-day history of vesicular skin lesions localized to the right side of abdomen and diffuse vesicular lesions on the face, trunk, abdomen and both arms (Fig. 1A e 1B).

BENIGN SOLITARY FIBROUS TUMUOR OF RETROPERITONEUM – A CASE REPORT.

Solitary brous tumuor (SFT) are rare variety of mesenchymal tumours. Most common location of SFT is pleura. 30% to 40% of SFTs occurs in extra-pleural regions (1). Retroperitoneal SFTs are very rare tumours with around 9 cases reported worldwide (2-7). It can be benign or malignant depending on cellularity, mitotic activity, necrosis and ki-67%. More than 4/mitosis per HPF is considered malignant (8). A 34-year-old lady presented with mass in right side of abdomen measuring 20x10cm, hard in consistency, mobile, no movement with respiration and crossing the midline. Ultrasound abdomen showed 20x11.5cm mass in retroperitoneum with compression of right kidney pelvis causing hydronephrosis. CECT abdomen showed 19.5x16.3x13.6cm mass in the retroperitoneum closely abutting right renal pelvis, adjacent pancreas, duodenum, inferior vena cava, psoas muscle posteriorly and abdominal wall anteriorly. After multidisciplinary tumour discussion surgery was planned for the patient. Patient underwent laparotomy with excision of retroperitoneal mass and right nephrectomy as the mass was densely adherent to right kidney. On histopathological examination of tumour spindle cells arranged in loose fascicles, thinned out wavy nuclei, eosinophilic cytoplasm with less than 3mitosis/ HPF was seen. On immunohistochemistry (IHC) tumour was diffusely positive for CD34 and STAT 6. Tumour was negative for SMA, Desmin, S-100, MUC4 and Beta-catenin. Ki-67% was 0-1%. Thus, a diagnosis of benign solitary brous tumour of retroperitoneum was made

Incidental finding of situs inversus totalis in a patient of carcinoma ovary

Situs inversus totalis is a very rare congenital defect with incidence rate of about 1:10,000 live births [1]. It is characterised by transposition of abdominal and thoracic organs, viscera and vasculature. It results from rotation inopposite direction of viscera and organs during organogenesis [2]. It is an autosomal recessive condition and sometimes it can be X linked and also found in identical twins [3]. Our patient was a 45 year old female who was diagnosed to have carcinoma ovary and underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. CT scan abdomen revealed this condition. Images show that her organs are simply transposition in sagittal plane. The heart is located on right side of thorax (dextrocardia) with right sided aortic arch. The left sided lung has three lobes and right sided lung has two lobes (Image 1). The stomach, spleen are located on right side of abdomen, whereas liver and gall bladder are on left side (Image 2a &amp; 2b). Blood vessels, lymphatics and intestines are also transpositioned. Uterus and ovaries can be seen absent. Patient was unaware of the condition throughout her life and it was incidentally diagnosed. This condition causes confusion for clinician as all the signs and symptoms will be on the other side of normal anatomical position of organ. It also complicates organ transplantation as donor organs will certainly come from situs solitus donors.

CONSERVATIVE MANAGEMENT OF ASHMARI WITH AYURVEDA: A CASE STUDY

Ashmari is one among the eight most difficult to cure diseases (Ashtamahagada) described in Ayurveda classical texts. The symptomatology of Ashmari resembles the clinical features of Urolithiasis mentioned in the contemporary medical science. Urolithiasis is third most common disease of the urinary tract. Conventional management of Urolithiasis does not have any effect on the pathogenesis of this disease and therefore, recurrence of disease occurs very commonly. Ayurveda has more radical approach and wide range of options in the management of urolithiasis. A 23-year old Indian male student presented with the complaints of pain in right side of abdomen, burning and difficulty in micturition since last 15 days. Per abdomen examination elicited tenderness on right lumbar region of abdomen and around right renal angle. No other abnormality detected during general and systemic examination. Ultrasonography (whole abdomen) revealed multiple right renal calculi (largest being 6.9 mm). On Ayurvedic parlance, the present case was diagnosed as Ashmari based on the signs and symptoms. Patient was prescribed the Ayurvedic medicines, Gokshuradi Gugguluand Varunadi Kashaya on OPD basis. Patient was advised to follow-up initially after 07 days and later after every fortnight. Improvement in clinical features was there within 07 days. Patient showed complete relief in his complaints on third follow-up visit. Repeat Ultrasonography scan did not revealed any renal calculus. Clinically also, Gokshuradi guggulu and Varunadi Kashaya has provided complete relief in pain, burning micturition and dysuria. It can be concluded that Gokshuradi guggulu and Varunadi Kashayamay lead to disintegration and expulsion of calculi and thus provide relief in signs and symptoms of Ashmari. This case illustrates the effective conservative management of Ashmari with Ayurvedic medicines with no adverse events and no episode of recurrence even after one year.

S2566 Large Intra-Abdominal Abscess in a Cirrhotic Patient With Ascites: A Rare Complication of Paracentesis?

INTRODUCTION: Ascites is a major complication of cirrhosis with 50% mortality in 2 years. Large-volume paracentesis (LVP) is safe and effective treatment for refractory ascites. Complications include bowel perforation, infection, bleeding, and ascitic fluid leakage. Abdominal abscess in cirrhotic patients with ascites has not been reported as a complication of LVP. We present a patient admitted with septic shock and a large abdominal abscess that may have represented a complication of paracentesis. CASE DESCRIPTION/METHODS: A 54-yo woman with ascites due alcoholic cirrhosis and untreated chronic hepatitis C had been managed with LVP every 2 wks for last 4 yrs. 2 d after her last tap, she presented locally with abdominal pain, hypotensive and in shock. She received fluids, pressors and IV antibiotics. CT showed 22 × 14 × 5 cm abscess in the right side of abdomen extending into prerectal area with foci of gas without definite communication with the bowel (Figure 1 A-B). She was transferred to our facility where, on arrival, she was afebrile, hypotensive, tachycardiac with a distended, diffusely tender abdomen with rebound tenderness. Labs showed WBC of 25.3 × 103/mm3 (90% neutrophils), hemoglobin 6.9 g/dL, platelets 555 × 103/mm3, total bilirubin 7.7 mg/dL, albumin 2.2 g/dL. Patient was admitted to ICU for pressors and IV antibiotics. A drain was placed in the abscess; the fluid grew pan-sensitive Enterococcus faecium, E. coli, Lactobacillus, and Candida dubliniensis. Fungal coverage added and she was discharged on 3 wks of IV piperacillin-tazobactam and fluconazole. Repeat CT 2 wks later showed improvement of the abscess and ascites (Figure 2 A-B). Antibiotics were stopped after repeat CT 3 wks later showed continued improvement (Figure 3). Several wks later, patient was admitted to local hospital with abdominal discomfort. Paracentesis excluded SBP but she died few days later of multi-organ failure. DISCUSSION: Intra-abdominal abscess resulting from or associated with paracentesis has not been reported in the literature. Our patient presented in shock with a large abscess 2 d after her last tap. No definite evidence of bowel perforation was seen on imaging, but the possibility that the abscess was caused by bowel injury secondary to paracentesis cannot be excluded. Whether the abscess was caused by the last tap before her acute illness or was already present is unclear, as ascitic fluid labs were not obtained.Figure 1.: A-B. CT abdomen pelvis cross sectional and coronal view showing a 22 × 14 × 5 cm abscess in the right side of the abdomen extending into prerectal region with foci of gas without definite communication with the bowel (solid white arrows).Figure 2.: A-B: CT abdomen pelvis cross sectional and coronal view showing improvement in size of the abscess (solid white arrows) and ascites.Figure 3.: CT abdomen pelvis cross sectional 6 weeks later showing interval improvement of abscess (solid white arrow) and ascites.

Primary omental infarction: a rare cause of acute abdomen

Primary omental infarction (POI) is a rare cause of acute abdomen. It frequently mimics other causes of acute abdomen. It is being diagnosed more frequently with the advancement of radiology. Here we report a case of a 35 years old man admitted in emergency with pain right side abdomen since past 2 days. On physical examination patient was febrile with tenderness and guarding over right side of abdomen, TLC (total leucocyte count) - 13.2×109/l, mild rise in bilirubin with rest blood investigations being normal. CT (computed tomography) abdomen was s/o omental infarction. On diagnostic laparoscopy gangrenous omentum with torsion over a vascular pedicle was noted, omentectomy was performed laparoscopically. In conclusion omental infarction should be kept as a differential diagnosis in acute abdomen especially right-side abdominal pathologies. It can be managed conservatively but if signs of sepsis are there it is wise to perform a diagnostic laparoscopy.

A Case of Persistent Retroperitoneal Abscess with Large Right Perinephric Collection

Introduction: Retroperitoneal abscess is a rare condition which is difficult to diagnose and treat because of its insidious onset and nonspecific clinical manifestations. Case Report: 55 years old male, underlying DM, Hypertension, Gouty arthritis. Referred to us for right Hypochondriac pain with persistent fever for past 2 days duration. Abdominal examination showed soft, tender over right side of abdomen, localized guarding. An abdominal CT scan showed right pyonephrosis complicated by a large right perirenal collection.Right Nephrostomy was performed. 1 week later, patient had fever and persistent right sided abdominal pain with increasing septic parameters. CT abdomen performed and showed Right pyonephrosis complicated by a large right perinephric abscess extending into the pelvic and inguinal region. Right Perinephric drainage performed. Patient developed worsening sepsis, repeated CT abdomen revealed residual multiloculated right perinephric collection. Open retroperitoneal drainage was performed, noted retroperitoneal abscsess, caccon right kidney and peritoneal, slough ,unhealthy tissue and necrotic debris over right psoas muscles.1 week after surgery, patient still not improving, repeated CT Abdomen showed features of D2 ischemia with focal retroperitoneal perforation causing large and recurrent right perinephric inflammation with increasing intraabdominal free fluid and enlarging right perinephric collection. Laparotomy done shiwed 1L clear ascites intraperitoneally, no pus collection seen. Cocoon inflammatory mass involving hepatic flexure and duodenum to the retroperitoneum, hepatic flexure appeared normal with no intraluminal mass.Right retroperitoneal exploration done, noted adhesion between hepatic flexure to Gerota's fascia, pus ~30ml at upper part of Gerota's fascia. Repeated CT abdomen showed slightly larger right paracolic gutter collection with similar right perinephric collection. Discussion: Retroperitoneal abscess is very rare. Retroperitoneal abscess may result from a variety of causes, such as pyelonephritis, pancreatitis, retroperitoneal appendicitis, diverticulitis, peptic ulcer disease, perforated cancer, infammatory bowel disease, spinal infection, trauma, and post instrumentation. For our patient ,the exact aetiology of retroperitoneal collection and peri renal collection are still unknown.

Right iliac fossa lump: a diagnostic surprise

A 42 years gentleman presented with recurrent urinary tract infection and intermittent lump in the right side of abdomen for 4 months. Clinically, soft cystic lump in the right iliac fossa with ill-defined lower margins, and disappeared on micturition. Contrast enhanced CT urography showing a large urinary bladder diverticulum of 107mm×52 mm. Cystoscopy confirmed a bladder diverticulum on left lateral wall of urinary baldder, superolateral to left ureteral orifice with no bladder trabeculations and bilateral normal ureteric orifice. Patient underwent open diverticulectomy with primary repair of urinary bladder wall done. Histopathology confirmed the presence of all layers in the wall of diverticulum. Postoperative period was uneventful. Patient resolved of symptoms in the 6 month follow up period.

A 2-year-old male child with diffuse abdominal pain, mass in the abdomen and red currant jelly stool

This article has no abstract. The first 100 words appear below: A 2-year-old male child, the second issue of non-consanguineous parents, from average socio-economic status hailing from Dinajpur, Bangladesh was attended at Pediatric Surgery outpatient department with the complaints of vague diffuse abdominal pain in the lower right side of abdomen and around the umbilical region for last 3 days. His mother also reported the feeling of a solid mass in the abdomen during dressing of her child. Then, gradually his problems were increasing in nature with several times of nausea, vomiting, and the passage of blood mixed stool three times before his admission.

Doppler ultrasound evaluation of heptobiliary system in leopards (Panthera pardus)

Ultrasonography has been considered as one of the most valuable diagnostic tools in veterinary medicine. The study standardizes the Doppler ultrasonographic hepato biliary biometric features in six leopards (Panthera pardus). The hepato biliary ultrasonographic examination was performed under general anaesthesia while lateral recumbency using a 3.5 MHz convex array transducer. The hepatobiliary images obtained at area covered the periphery just behind the sternum and last ribs of thorax on left and right side of abdomen. Gall bladder was visualized at a moderate pressure below the level of sternum. The hepato biliary measurements were recorded and it can be concluded that Doppler ultrasonography as valuable technique for measuring hepato biliary biometric features and could be used as reference values for diagnosis of hepato biliary diseases and disorders in leopards.

Refractory Ileal Fecaloma Causing Small Bowel Obstruction

Fecalomas are extremely rare and often occur in the in the rectum and sigmoid colon. In patients with multiple comorbidities limiting clinical decisions, it is important to understand the treatment options available with fecalomas and their outcomes. Here we present a 61-year-old ventilator-dependent male with advanced dementia, status post heart and lung transplant, and status post prior small bowel resection for unclear reasons who presented with abdominal distention and bilious emesis following a recent hospitalization for respiratory failure secondary to pneumonia. Vitals were notable for tachycardia to the 110s and exam was significant for palpable stool along the right side of abdomen. An abdominal radiograph revealed dilated loops of small and large bowel with air-fluid levels (Figure 1). Conservative treatment with a nasogastric tube, crystalloids, and rectal laxatives were unsuccessful. An abdominal CT scan showed a dilated fluid-filled small bowel extending to distal ileum where there was a 9 cm stool ball in a postsurgical aperistaltic segment of bowel with distinct transition point (Figure 2). Multiple attempts at laxatives from patient's gastrostomy tube and rectally were trialed with no significant improvement in patient's abdominal distension and pain. Unfortunately, the patient was a poor candidate for surgery due to his multiple comorbidities. The family ultimately decided to pursue hospice. Fecalomas, or hard intraluminal tumor-like mass of feces, are most commonly found in the rectum and sigmoid colon. It has been more commonly reported in patients with old age, long-term enteral feeding, and neuropsychiatric disease, likely leading to sluggish bowel function. Fecalomas in the small bowel causing obstruction has only been reported in a 10-year-old boy. Fecalomas in the distal colon are often managed by conservative methods such as bowel rest, rectal suppositories, enemas, digital evacuation and rectal decompression. More aggressive treatments include endoscopic disimpaction and surgical intervention for those who are otherwise good surgical candidates. Our case posed a management dilemma in that the fecaloma was located in an aperistaltic segment of the ileum rather than more distally, making colonoscopic decompression difficult, and as patient was not a surgical candidate, surgery was a nonviable option. Since patient has exhausted all conservative managements, comfort care became the best available option.Figure: An abdominal radiograph showing dilated loops of small and large bowel obstruction with air-fluid levels.Figure: An abdominal CT scan showing a 9 cm stool ball in a postsurgical aperistaltic segment of bowel with a distinct transition point.

Paralytic ileus due to Toxoxcara vitulorum in a calf and its management

Present communication reports about the rare case of paralytic ileus in a calf and its successful management. A two-month-old buffalo calf was referred to the hospital, with history of not passing dung and intermittent colic signs. On clinical examination, severe dehydration, congested mucus membranes, elevated vital parameters, empty rectum and fluid splashing sounds on the right side of abdomen were observed. Ultrasonographic examination revealed the distended proximal intestinal loops along with thickened intestinal wall and empty colon. Case was treated with oral piperazine compound at 200 mg/kg body weight, liquid paraffin at 5 ml/kg body weight along with fluid therapy. On the second day of treatment, the calf was passed the huge number of the Toxocara vitulorum worms and uneventful recovery was noticed after eight days of therapy.

Retroperitoneal Hydatid Cyst: Case Report

Hydatid disease (HD) is an infestation that is caused by the larval stage of Echinococcus granulosus. The liver is affected in approximately two-thirds of patients, the lungs in 25%, and other organs in a small proportion. Primary retroperitoneal hydatid cyst is extremely rare. The most common complaint is abdominal pain; however, the clinical features of HD may be generally dependent on the location of the cyst. Herein we report a new case of primary retroperitoneal hydatid cyst diagnosed with abdominal pain and palpable large mobile mass on the right side of abdomen.

Chronic intermittent abdominal pain in young woman with intestinal malrotation, Fitz-Hugh-Curtis Syndrome and appendiceal neuroendocrine tumor: a rare case report and literature review.

BackgroundThere are a lot of different causes of abdominal pain; in this case, a young woman suffers from three diseases with similar symptoms. Adult intestinal mal-rotation is a rare condition of deviation from the normal 270° counter clockwise rotation of the midgut resulting in, not only mal-position of the small intestine, but also mal-fixation of the mesentery. Fitz-Hugh-Curtis syndrome is a rare complication of pelvic inflammatory disease; it involves liver capsule inflammation associated with genital tract infection, which is usually caused by Neisseria gonorrhoea and Chlamydia trachomatis. Neuroendocrine tumors are enterochromaffin cell neoplasms that arise from cells of the endocrine (hormonal) and nervous systems; the appendicular one is the most common primary malignant lesion of these tumors, it’s incidence is about 0.3 – 0.9 % of appendectomies done. Just for knowledge, this is the first described case of concomitant presence of all these diseases with clinical symptoms attributable to each one.Case presentation40-years-old woman suffers from acute abdominal pain, predominantly on the right quadrants, without abdominal distension, no guarding nor rigidity and normal intestinal peristalsis. She has a long history of abdominal intermittent pain, with cramps every 30–40 min, resolving spontaneously. She was diagnosed as intestinal mal-rotation through computed tomography scan which has evidenced a mobilized intra - peritoneal duodenum with cecum/ascending colon predominately lying on the left side and the small intestine almost entirely lying on the right side of abdomen, without evidence of effusion, edema or signs of intestinal ischemia or infarction. Exploratory laparoscopy demonstrated an inflammatory process in the hepatic-renal space, with bloody adhesions above the liver capsule; this is additional to the typical pelvic inflammatory disease signs (Fitz-Hugh-Curtis syndrome). Appendectomy was performed with histological analysis resulting in appendicular neuroendocrine tumor.ConclusionsAlthough the patient has an intestinal mal-rotation which could explain the abdominal painful symptoms, it is not possible to exclude other concomitant causes, such as perihepatitis on pelvic inflammatory disease or neuroendocrine tumors. Even if all these diseases are rarely seen in daily clinical practice, they should be considered in the differential diagnosis of chronic intermittent abdominal pain in a young woman.

Surgical approach to right colon cancer: From open technique to robot. State of art.

This work is a topic highlight on the surgical treatment of the right colon pathologies, focusing on the literature state of art and comparing the open surgery to the different laparoscopic and robotic procedures. Different laparoscopic procedures have been described for the treatment of right colon tumors: Totally laparoscopic right colectomy, laparoscopic assisted right colectomy, laparoscopic facilitated right colectomy, hand-assisted right colectomy, single incision laparoscopic surgery colectomy, robotic right colectomy. Two main characteristics of these techniques are the different type of anastomosis: Intracorporeal (for totally laparoscopic right colectomy, single incision laparoscopic surgery colectomy, laparoscopic assisted right colectomy and robotic technique) or extracorporeal (for laparoscopic assisted right colectomy, laparoscopic facilitated right colectomy, hand-assisted right colectomy and open right colectomy) and the different incision (suprapubic, median or transverse on the right side of abdomen). The different laparoscopic techniques meet the same oncological criteria of radicalism as the open surgery for the right colon. The totally laparoscopic right colectomy with intracorporeal anastomosis and even more the single incision laparoscopic surgery colectomy, remain a technical challenge due to the complexity of procedures (especially for the single incision laparoscopic surgery colectomy) and the particular right colon vascular anatomy but they seem to have some theoretical advantages compared to the other laparoscopic and open procedures. Data reported in literature while confirming the advantages of laparoscopic approach, do not allow to solve controversies about which is the best laparoscopic technique (Intracorporeal vs Extracorporeal Anastomosis) to treat the right colon cancer. However, the laparoscopic techniques with intracorporeal anastomosis for the right colon seem to show some theoretical advantages (functional, technical, oncological and cosmetic advantages) even if all studies conclude that further prospective randomized trials are necessary. Robotic technique may be useful to overcome the problems related to inexperience in laparoscopy in some surgical centers.

Gastrointestinal autonomic neural tumour of colon: a case report of rare unusual tumour of colon

Gastrointestinal autonomic nerve tumours (GANTs) are uncommon stromal tumors of the intestinal tract. They can involve any part of the gastrointestinal system, but are very rarely seen in the Colon. We report a unique case of Gastrointestinal Autonomic Neural Tumour (GANTs) of colon extending from ascending colon to 2/3rd of the transverse colon. A 50-year-old male patient was admitted with complaint of pain in right side of abdomen. USG revealed f/s/o lymphoma/Carcinoma Colon. CECT Abdomen revealed? Lymphoma? Carcinoma extending from ascending colon to 2/3rd of the transverse colon with Lymphadenopathy. Exploratory Laparotomy was performed followed by Right Hemicolectomy. Histopathology and Immunohistochemistry confirmed the colonic lesion to be a Gastrointestinal Autonomic Neural Tumour. Literature review of the few reported cases has suggested radical surgical excision to be the best approach. Prognosis tends to be favourable after resection. Gastrointestinal Autonomic Neural Tumour. Literature review of the few reported cases has suggested radical surgical excision to be the best approach. Prognosis tends to be favorable after resection.