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188 Kumar S. et al.Jurnalul de Chirurgie (Iaşi), 2013, Vol. 9, Nr. 2Urethral fistula may require reconstruction.Urethral stricture may be a latecomplication.CONCLUSIONAspiration and puncture techniquefacilitates the removal of constricting objectsfrom the penis. This technique is safe anddoes not require sophisticated equipment.The procedure saves valuable time andhence may prevent development ofirreversible ischemic changes in many cases.In our case the technique was usedsuccessfully with an uneventful recovery.CONFLICT OF INTERESTThe author and co-author have noconflict of interest.REFERENCES1. Bhat AL, Kumar A, Mathur SC, Gangwal KC.Penile Strangulation. British J Urol. 1991; 68:618-621.2. Snoy FJ, Wagner SA, Woodside JR, OrgelMG, Borden TA. Management of penileincarceration. Urology. 1984; 24: 18-20.3. Klein FA, Smith MJ. Treatment ofincarceration of the penis by tempered steelbushings. J Emerg Med. 1987; 5(1): 5-8.4. Kadioglu A, Cayan S, Ozacn F, Tellaloglu S.Treatment of penile incarceration in animpotent man. Int Urol Nephrol. 1995; 7: 639-641.5. Shuster G, Stockmal P. Genital incarcerationwith metal rings; their safe removal.Techniques in urology. 1999; 5: 116-118.6. Flatt AF. The care of minor hand injuries. 2nded. St. Louis: CV Mosby; 1963. p. 262-263.7. Vahasarja VJ, Hellstrom PA, Serlo W,Kontturi MJ. Treatment of penile incarcerationby the string method: two case reports. J Urol.1993; 149: 372-373.8. Detweiler MB. Penile incarceration with metalobjects: A review of procedure choice basedon penile trauma grade. Scand J Urol Nephrol.2001; 35: 212-217.9. Punekar SV, Shroff RR, Vaze ML. An unusualcase of strangulation of penis by metalhammer head( a case report). J Postgrad Med.1978; 24: 58-59.10. Sinha BB. Penile incarceration by a metal ring.Br J Surg. 1988; 75: 33.11. Bermudez AMT. Incarceration del pene porobject metalico pesado. Arch Esp de Urol.1998; 51: 483-484.
CASE REPORT 189Jurnalul de Chirurgie (Iaşi), 2013, Vol. 9, Nr. 2GIANT SUBMUCOSAL GASTRIC LIPOMA – CASE REPORTMaria-Gabriela Aniţei 1 , I. Huţanu 1 , A. Gervescu 1 , Oana Simionescu 1 ,Nora Lefter 2 , V. Scripcariu 11) University of Medicine and Pharmacy “Gr.T. Popa” Iaşi, RomaniaFirst Surgical Oncology Unit, Regional Institute of Oncology, Iaşi, Romania2) Municipal Hospital, Gastroenterology Unit, Gura Humorului, RomaniaGIANT SUBMUCOSAL GASTRIC LIPOMA – CASE REPORT (Abstract): Gastric lipomas arerare benign tumors, representing less than 1% of all gastric tumors. They often have a submucosalorigin, but in rare cases could originate in the subserosa. We report the case of a 72 year-old malewho presented dyspeptic syndrome and superior gastro-intestinal bleeding (melena). The uppergastrointestinal endoscopy revealed a large, almost stenotic, submucosal oval-shaped mass, with adiameter of 10 cm located in the gastric antrum, with an area of ulcerated gastric mucosa. Theabdominal computer tomography revealed a homogeneous well-defined mass with negativedensitometry values that corresponded to the fatty tissue. The tumor was enucleated throughantrotomy, with an uneventful postoperative course. CONCLUSION: Although rare, the gastriclipoma can be a cause of gastrointestinal bleeding, mimicking a malignant tumor.KEY WORDS: GASTRIC LIPOMA; GASTROTOMY; TUMOR ENUCLEATIONSHORT TITLE: Gastric lipomaHOW TO CITE: Aniţei MG Huţanu I, Gervescu A, Simionescu O, Lefter N, Scripcariu V. Giant submucosal gastriclipoma – case report. Jurnalul de chirurgie (Iaşi). 2013; 9(2): 189-192. DOI: 10.7438/1584-9341-9-2-12.INTRODUCTIONGastrointestinal lipomas are rarebenign tumors that may occur anywherealong the gut. Most of them are located inthe colon, ileum and jejunum [1,2]. Withonly 220 cases reported in the literature [1-4], gastric lipomas are even more unusual,and they occur mostly in the antrum havinga submucosal origin [5]. The imagingexamination can be highly suggestive for thediagnosis, while the histological examinationoffers the final and certain diagnosis.Computed Tomography (CT scan) is theimaging examination of choice for obtaininga specific diagnosis of lipoma [6]. However,the tumor may sometimes undergosignificant inflammatory changes leading toa difficult differential diagnostic with thewell-differentiated liposarcoma.CASE REPORTWe examined a 72 years old man witha 4 month history of dyspeptic disorder,fatigue and melena, and without significantweight loss. He was previously medicallytreated with i.v. fluids and haemostatics. Themedical history was significant forhypertension, atrial fibrillation and heartfailure stage II NYHA. The administeredmedication included warfarin, diuretics,clopidogrel, angiotesin II receptor blocker,calcium channels blockers and selectivebeta-blocker.Physical examination reveals an obesepatient (BMI=30.5 kg/m 2 ), with a generalgood status, and slightly pale teguments. Theabdomen was flat and soft, with mildtenderness in epigastrum and no palpablemasses.Received date: 28.02.2013Accepted date: 25.03.2013Correspondance to: Maria-Gabriela Aniţei, MDFirst Surgical Oncology Unit, Regional Institute of Oncology IaşiStr. General Henri Mathias Berthelot no 2-4, 700483 Iaşi, RomaniaPhone: 0040 (0) 374 27 88 10Fax: 0040 (0) 374 27 88 02E-mail: dr.mgabriela@gmail.com
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