Aneurysm Scaphoid

Scaphoid aneurysm. Aneurysm of the peritoneum and pelvic arch. Epihepatic belt. Hemocolmecteremia

Aneurysmal dilatation and elongation of the terminal portion of the ileum at its junction with the peritoneum.

Diagnosis: **Ileocolic aneurysm, rupture. Main disease: Acute intestinal obstruction without intestinal perforation.** Acute ischemic colic for surgical indications. Complaints of pain in the upper abdomen, vomiting and constipation. The diagnosis was made on the basis of palpation + CT. CT scan reveals expansions with a convex thickening of the wall of the ileum with displacement of the abdominal organs upon palpation above the navel. Surgical treatment was performed according to the following description. Pancreatic necrectomy was performed. There are no allocations. Nodal anastomosis.

Progress of the operation:

1. Urethral fistula, which denies access to the rectum and bladder. A large scrotum, a large uterus, a full bladder, which is captured by the VMI loop - all this interferes with the operation. In addition, access to the right side of the abdominal cavity is difficult. I am counting on the possibility of subsequent closure of the vaginoperitoneovaginoendosfistula or access through a wound into the sacro-abdominal-inguinal fold. The abdominal cavity is opened normally. I cut off the DMS loop and the spleen capsule. It has a sclerotic surface, which confirms the diagnosis of rupture of an ileal aneurysm. There is no mesentery of the anterior abdominal wall, it is not carved into the abdominal cavity - the main sign of intestinal obstruction. 2. Numerous free fluids in the abdominal cavity, a confluent anechoic area to the right of the colon confirms this. The leaves of the peritoneum are covered with petechial hemorrhagic eczema, which also confirms this assumption. The predominant lesion of the outer layer of the peritoneum is a strangulated hernia on the right behind. This was always confirmed during this operation. Please note that visually there is no peristalsis everywhere. What we know for sure happens with subloop obstruction. The cones were removed and the rib fracture was repaired. A scalloped intestinal aneurysm with a tense periphery and an expanded diameter of up to 5 cm is the main definition of this study and diagnosis from complaints. Intestinal hemangioma is an intraluminal hematoma, slightly expanded on its own.