Malign over tümör bulgularını taklit eden koledok yaralanması: Olgu sunumu
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Tarih
2011
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info:eu-repo/semantics/openAccess
Özet
Amaç: Malign over tümör bulguları saptanıp operasyona alınan ve intraoperatif koledok yaralanması tanısı konulan bir olgunun sunulması. Olgu Sunumu: 26 yaşında bayan hasta, karında şişlik şikayeti ile kliniğimize başvurdu. Hastanın anamnezinden 2 ay önce kolelitiazis nedeniyle laparaskopik kolesistektomi ameliyatı geçirdiği öğrenildi. Hastanın muayenesinde batın distandü görünümde idi. Tranvajinal ultrasonografisinde sağ adneksiyel alanda 63X60 mm ebadında solid komponentleri olan, septasyon içeren kistik yapı, batında iç yoğunluğu hafif yüksek yaygın serbest sıvı gözlendi. Labaratuvarda bilurubin değerleri normal, CA 125: 481 U/L, albumin: 2.0 gr/dl olarak tespit edildi. Hasta over tümörü ön tanısı ile operasyona alındı, batın gözleminde 7-8 litre sarı- yeşil, safra benzeri sıvı boşaltıldı, intraoperatif genel cerrahi konsültasyonu istendi. Koledokta geçirilmiş laparaskopik kolesistektomi ameliyatına bağlı 2-3 adet klips tespit edildi, injury bölgesi tamir edilerek, koledok kanalına T-tüp yerleştirildi. Sağ overden kaynaklanan 60X70 mm ebadında solid komponentleri olan kistik yapı izlendi. Hastaya sağ salphingooferektomi yapılarak frozene gönderildi, sonucu benign olarak bildirildi. Hasta postoperatif 4. gününde sorunsuz olarak taburcu edildi. Sonuç: Serum CA 125 yüksekliği ile gelen hastalarda etyoloji iyice araştırılmalı, anamnez ayrıntılı bir şekilde alınmalı ve geçirilmiş cerrahi operasyon öyküsü olanlarda olası komplikasyonlar akılda tutulmalıdır. was repaired, and T-tube was inserted in the common bile duct. A 60x70 cm sized cyst with solid components was seen arising from the right ovary. Right salpingoophorectomy was done for the patient and was sent to frozen pathology, the result was reported as benign. The patient was discharged on postoperative 4th day. Conclusion: In patients with elevated serum CA 125 values, the etiology should be thoroughly investigated, a detailed medical history should be taken and possible complications should be considered in patients with history of previous surgery.
Objective: To present a case that was suspected to have malignant ovarian tumor and operated on, intraoperative findings revealed bile duct injury. Case Presentation: A 26 year old female patient presented to our clinic with abdominal distension. The patient had history of laparoscopic cholecystectomy due to cholelithiasis before 2 months. In her abdominal examination, the abdomen was distended. In the transvajinal ultrasound examination, 63X60 mm sized cystic structure with septation and solid components were seen in the right adnexial region. Increased amount of slightly high density free fluid was observed in the abdomen. In the laboratory investigations, she had normal value of bilirubin, CA 125: 481 U/L, albumin: 2.0 g / dl. The patient was operated on with the diagnosis of ovarian tumor. 7-8 litres of yellow-green, bile-like fluid were drained from the abdomen; intra-operative general surgical consultation was requested. Due to previous laparoscopic cholecystectomy surgery, 2-3 pieces of clips were seen in common bile duct, injury region
Objective: To present a case that was suspected to have malignant ovarian tumor and operated on, intraoperative findings revealed bile duct injury. Case Presentation: A 26 year old female patient presented to our clinic with abdominal distension. The patient had history of laparoscopic cholecystectomy due to cholelithiasis before 2 months. In her abdominal examination, the abdomen was distended. In the transvajinal ultrasound examination, 63X60 mm sized cystic structure with septation and solid components were seen in the right adnexial region. Increased amount of slightly high density free fluid was observed in the abdomen. In the laboratory investigations, she had normal value of bilirubin, CA 125: 481 U/L, albumin: 2.0 g / dl. The patient was operated on with the diagnosis of ovarian tumor. 7-8 litres of yellow-green, bile-like fluid were drained from the abdomen; intra-operative general surgical consultation was requested. Due to previous laparoscopic cholecystectomy surgery, 2-3 pieces of clips were seen in common bile duct, injury region
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