TY - JOUR
T1 - Multivisceral resection for colonic splenic flexure malakoplakia
T2 - a case report of a minimally invasive approach
AU - Díaz, Andrés Ramiro Lanza
AU - Pezet, Santiago Gallardo
AU - González, Osvaldo Soto
AU - Trueba, Montserrat Guraieb
AU - Alonso, Ivan Azael Martínez
AU - Ramirez, Mario Alberto L.
N1 - Publisher Copyright:
© 2023 The Korean Society of Coloproctology.
PY - 2023
Y1 - 2023
N2 - Malakoplakia is a rare granulomatous inflammatory disorder. Its diagnosis depends on histopathological findings; however, high-quality literature regarding proper medical/surgical treatment is lacking. A 38-year-old diabetic female patient was admitted to the emergency room with a history of lower gastrointestinal hemorrhage. Colonoscopy revealed a lesion in the descending colon, and abdominal computed tomography revealed a splenic flexure mass involving the lower pole of the spleen and upper pole of the left kidney. Biopsies confirmed the diagnosis of malakoplakia. After completing antibiotic treatment, a restaging computed tomography revealed a discrete mass increase; hence, the patient underwent laparoscopic en bloc colectomy and partial nephrectomy. Postoperatively, the patient developed a pancreatic fistula, which was successfully treated with percutaneous drainage and antibiotics. The presence of pathognomonic Michaelis-Gutmann inclusions on histopathology is frequently reported as the key to diagnosing malakoplakia. Herein, we present a successful, minimally invasive surgical treatment for colonic malakoplakia.
AB - Malakoplakia is a rare granulomatous inflammatory disorder. Its diagnosis depends on histopathological findings; however, high-quality literature regarding proper medical/surgical treatment is lacking. A 38-year-old diabetic female patient was admitted to the emergency room with a history of lower gastrointestinal hemorrhage. Colonoscopy revealed a lesion in the descending colon, and abdominal computed tomography revealed a splenic flexure mass involving the lower pole of the spleen and upper pole of the left kidney. Biopsies confirmed the diagnosis of malakoplakia. After completing antibiotic treatment, a restaging computed tomography revealed a discrete mass increase; hence, the patient underwent laparoscopic en bloc colectomy and partial nephrectomy. Postoperatively, the patient developed a pancreatic fistula, which was successfully treated with percutaneous drainage and antibiotics. The presence of pathognomonic Michaelis-Gutmann inclusions on histopathology is frequently reported as the key to diagnosing malakoplakia. Herein, we present a successful, minimally invasive surgical treatment for colonic malakoplakia.
KW - Colectomy
KW - Malakoplakia
KW - Minimally invasive surgical procedures
KW - Nephrectomy
KW - Type 2 diabetes mellitus
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U2 - 10.3393/ac.2021.00178.0025
DO - 10.3393/ac.2021.00178.0025
M3 - Article
C2 - 34284559
AN - SCOPUS:85146791189
SN - 2287-9714
VL - 39
SP - 178
EP - 182
JO - Annals of Coloproctology
JF - Annals of Coloproctology
IS - 2
ER -