Faculty of Medicine
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Item type:Publication, Pancreas and duodenum herniation in a giant inguinal hernia sac in a patient with severe scoliosis: a rare case report(Oxford University Press (OUP), 2025-07); ; ; Giant inguinal hernias (GIHs) are rare clinical entities, typically containing omentum or small bowel. Involvement of retroperitoneal organs, such as the pancreas and duodenum, is exceedingly uncommon due to their fixed anatomical positions. We report a unique case of a 52-year-old male with a longstanding right GIH and severe scoliosis, in whom preoperative imaging and surgical exploration revealed herniation of the pancreatic head and duodenum into the hernia sac. Contributing factors included altered retroperitoneal geometry from spinal curvature, reduced abdominal wall tone, and congenital right hip displacement with associated functional limitation. Incidental findings of multiple left hepatic duct calculi raised concerns for biliary stasis due to chronic duodenal displacement. This case highlights the importance of considering atypical hernia content in patients with longstanding hernias and complex musculoskeletal deformities, and underscores the role of comprehensive imaging and multidisciplinary assessment in surgical planning. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Uncommon degloving intestinal injury accompanied by complete disruption of the rectus muscles in patient with seat belt sign: a case report(Oxford University Press (OUP), 2025-07); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Laparoscopic cholecystectomy in situs inversus totalis: A case report(Centre for Evaluation in Education and Science (CEON/CEES), 2021); ; Situs inversus totalis represents a rare autosomal recessive morphological anomaly of the internal viscera, equally affecting both genders. The genetic defect occurs in the 2nd week of embryonic life, when a 270-degree clockwise rotation of the primitive digestive tube occurs. The incidence of calculosis of gallbladder in patients with situs inversus is the same as in the general population. A 61-year-old female patient with a history of four episodes of colicky, left hypochondrium and epigastric pain, without fever and jaundice, was admitted for elective laparoscopic cholecystectomy. CT of abdomen confirmed situs inversus totalis that was previously known to the patient. The patient was positioned in supine position and a mirror image configuration of the operating room was obtained, with surgeon and scrub nurse on the right side and assistant on the left side of the patient. Four trocars were introduced mirroring the standard position of the 5 mm trocars. During the dissection, second assistant was introduced for the laparoscope, due to the surgeon's limited motor skills in his left hand for delicate dissection, rendering him inapt to perform precise and safe dissection. The total operating time amounted to 110 minutes, which is three times longer than the standard operating time at our institution. The most critical point of the operation in constellation of situs inversus totalis is applying the clips, which requires precision and strength in the same moment. In the available literature, 40 open cholecystectomies before introduction of laparoscopy and 92 laparoscopic cholecystectomies were reported. To our knowledge, this is the first and the only reported laparoscopic cholecystectomy for situs inversus in North Macedonia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Low-grade malignancy glomus tumor of the abdominal wall: a case report and literature review(Oxford University Press (OUP), 2023-12); ; ; ; Gelevski, RadomirGlomus tumors are painful neoplasms arising from the glomus body (responsible for body temperature and blood pressure regulation) in the skin. Although mostly present in the interdigital areas, glomus tumors can arise elsewhere. The vast majority of them are benign. Rarely, malignant variants are reported and are associated with the potential for local infiltration and metastatic dissemination. The abdominal wall location of glomus tumors is extremely rare regardless of whether they present as benign or malignant. We present a case of a 58-year-old female patient with a low-grade malignancy infiltrative glomus tumor of the abdominal wall.