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This is the first reported case of superior mesenteric artery syndrome secondary to biliary dyskinesia. SMA syndrome involves obstruction of the third portion of the duodenum, causing a gastric outlet obstruction due to narrowing of the space between the abdominal aorta and the superior mesenteric artery (SMA). Rapid weight loss has been shown to be a risk factor for this condition. We report a case found in a 14-year old Hispanic developmentally delayed female and review the literature. Our patient presented with a one-month history of abdominal pain, bilious emesis, and weight loss. She was seen at an outside facility where she had two abdominal operations without symptomatic relief. A HIDA scan performed at our facility was consistent with biliary dyskinesia, and an UGIS confirmed a concomitant SMA syndrome. An open cholecystectomy with a side-to-side duodenojejunostomy was performed. Postoperatively, patient continued with gastropareisis, requiring nutritional support via TPN and insertion of a jejunostomy tube. On post operative day 24, patient was discharged home tolerating full feeds. She has since been seen in follow up, and is doing well. (C) 2016 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license
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A Large Intussuscepting Gastric Lipoma
Lipomas of the lower foregut are exceptionally rare. Presenting symptoms often include bleeding, weight loss, and obstructive symptoms. Surgical resection remains the standard treatment. We report a case of a large intussuscepting gastric lipoma.
PMID: 29255956
ISSN: 1873-4626
CID: 3463442
Two birds, one surgical stone: The first reported case of superior mesenteric artery syndrome secondary to biliary dyskinesia
ISI:000381625400012
ISSN: 2213-5766
CID: 3463432
CASE REPORT Papillary Fibroelastomas and the Conundrum of the Benign Intracardiac Mass
Cardiac papillary fibroelastomas are a rare form of benign, primary cardiac tumor. They tend to develop from the valvular endocardium, with nonvalvular locations being uncommon. They are primarily found on either the mitral or aortic valve. They account for 7% of all primary cardiac tumors. Papillary fibroelastomas are usually identified through either transthoracic echocardiography or transesophageal echocardiography. The latter is more likely to provide a clearer diagnosis. Management remains controversial. The benign histology notwithstanding, the prevailing consensus is toward excision of left-sided cardiac lesions due to the risk of coronary and cerebral embolization. While the diagnosis of cardiac papillary fibroelastomas is relatively rare, the likelihood of encountering a right-sided lesion with rapid growth in a 6-month period is extraordinary. We highlight a case where an 84-year-old man with coronary artery disease was found to have a right atrial mass attached to the tricuspid valve. This mass grew by more than 1 cm in a 6-month period.
PMID: 22724043
ISSN: 1937-5719
CID: 3463422
