We present the case of a 58-years-old caucasian male who was hospitalized in our hospital with an early diagnosis of a jejunal tumor. However, all the instrumental and laboratory testing conducted ...were inconclusive and a preoperative diagnosis was not established. Patient was scheduled for surgery and en-bloc resection of the jejunal mass was performed. Microscopic analysis of the specimen reported the presence of intense mixed lympho-granulocytic inflammatory infiltrate of the mucosa associated with entamoeba parasites and a diagnosis of intestinal ameboma was ruled out. Ameboma is a rare complication of chronic amoebic colitis. usually found in the cecum and ascending colon. To our knowledge, this is the first case of an intestinal ameboma involving the jejunum to be reported in medical literature.
In the past 20 years, the approach to biliary lithiasis has changed tremendously as a result of advances in endoscopic and laparoscopic techniques. The two most important open surgical techniques ...involve extraction of the stones from the common bile duct combined with choledochoenterostomy and papillotomy followed by transduodenal papillosphinteroplasty. Ideally, the choledochotomy is followed by the insertion of a T-tube in the common bile duct. The transcystic approach has never been considered. The first endoscopic papillotomy was performed in 1973. Subsequently, it became the most widely used method for removal of common bile duct stones. In this report we explore the possibility of performing a laparoscopic transduodenal papillosphincteroplasty, following the strict rules commonly used in surgery. After cholecystectomy, a Fogarty catheter, is introduced through the cystic duct. This is followed by a minimal duodenotomy, then incision of the papillar sphincter. In this surgical proposal, we do not intend to substitute technique, but this method should be considered the ultimate solution in the laparoscopic approach to cholecystic choledocholithiasis.
