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Unusual complication in patient with Gardner's syndrome: Coexistence of triple gastrointestinal perforation and lower gastrointestinal bleeding: A case report and review of literature

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World Journal of Clinical Cases 2018年第10期6卷 393-397页

作者： Sami Akbulut Cemalettin Koc abuzer dirican Department of Surgery and Liver Transplant Institute Inonu University Faculty of Medicine

Gardner's syndrome(GS) is a rare syndrome with autosomal dominant inheritance, which is characterized by multiple intestinal polyps, dental anomalies, desmoid tumors, and soft tissue tumors. All gastrointestinal symptoms seen in GS are associated with the underlying familial adenomatosis polyposis and abdominal desmoid tumors, with the most common symptoms being anemia, lower gastrointestinal bleeding, abdominal pain, diarrhea, obstruction, and mucous defecation. To our best knowledge, no case of GS that has presented with gastrointestinal perforation and bleeding has ever been reported in the English language medical literature. A 37-year-old male who had been diagnosed with GS five years earlier was referred to our clinic for lower gastrointestinal bleeding. Despite the absence of a bleeding focus on conventional angiography, the patient was operated on with laparotomy, due to the persistence of both signs and symptoms of mild peritonitis. On the laparotomy, the patient was noted to have areas of perforation in the duodenum, splenic flexura, and midrectum. The third and fourth part of the duodenum, the proximal 15 cm segment of the jejunum, a 10 cm segment of the terminal ileum, the whole colon, and the upper and middle rectum were resected, and duodenojejunal side-to-side anastomosis and terminal ileostomy were performed. The histopathological analysis of the large mass measuring 30 cm × 20 cm was reported as a desmoid tumor. The pathological examination of the tumor foci detected in the colonic specimen revealed poorly differentiated adenosquamous carcinoma.

关键词： Gastrointestinal perforation Gastrointestinal bleeding Adenosquamous carcinoma Complications Gardner’s syndrome

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Is right lobe liver graft without main right hepatic vein suitable for living donor liver transplantation?

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World Journal of Hepatology 2020年第7期12卷 406-412页

作者： Khaled Demyati Sami Akbulut Egemen Cicek abuzer dirican Cemalettin Koc Sezai Yilmaz Department of Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Turkey An-Najah National University Hospital An-Najah National UniversityNablus 11941Palestine

BACKGROUND Since the first living donor liver transplantation(LDLT)was performed by Raia and colleagues in December 1988,LDLT has become the gold standard treatment in countries where cadaveric organ donation is not *** hepatic venous outflow reconstruction in LDLT is essential to prevent graft congestion and its complications including graft ***,this can be complex and technically demanding especially in the presence of complex variations and congenital anomalies in the graft hepatic *** SUMMARY Herein,we aimed to present two cases who underwent successful right lobe LDLT using a right lobe liver graft with rudimentary or congenital absence of the right hepatic vein and describe the utility of a common large opening drainage model in such complex *** Thanks to this venous reconstruction model,none of the patients developed postoperative complications related to venous *** experience with venous drainage reconstruction models shows that congenital variations in the hepatic venous structure of living liver donors are not absolute contraindications for LDLT.

关键词： Living donor liver transplantation Congenital-absence of right hepatic vein Common large opening drainage model Case report

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