Experience with hydatid disease in Yemen

One hundred patients with 12 hepatic hydatid cysts and twenty patients with pulmonary hydatid cysts were managed in a 6-month period. Most of the patients were females [87.5%]. Both hypertonic saline [10%] and povidone iodine [10%] were used as scolicidal agents. The latter solution is highly recommended as moist sponges to pack off the cyst and to flush the cyst before removal of the laminated membrane. Non-completed cysts [60 cases] were managed by either omentoplasty or closure over hypertonic saline. Omentoplasty has been done using a pedicled omental flap based on either the right or left gastroepiploic vessels. Infected cysts were managed by external tube drainage; two temporary external biliary fistulas occurred. Intra-biliary rupture occurred in 10 cases. It was managed by T-tube drainage supplemented in two cases by choledochoduodenostomy. Pulmonary cysts were managed by aspiration-evacuation technique. Closure of the communication with the bronchial tree was done in 9 cases. Deliberate endobronchial ventilation was done in all cases. No deaths occurred in this series

Percutaneous transhepatic cholangiography and drainage in patients with obstructive jaundice

Twenty-seven patients with obstructive jaundice were subjected to clinical examination, laboratory investigations as well as percutaneous transhepatic cholangiography [PTC]. Thirteen patients in whom the general condition was poor and / or serum bilirubin above 15 mg% were subjected to percutaneous transhepatic drainage one week prior to operation. We found that PTC is a safe and effective procedure for demonstrating the site, nature and extent of the obstructing lesion as it was successful in 85.1% and 92.5% of patients to diagnose the cause and site of obstruction respectively. PTD, is a safe procedure and can accomplish adequate decompression of the biliary tree and marked improvement of liver functions and general condition before operation. It has a definite indication as a palliative procedure in non-resectable tumours in bad risk patients. No mortality occurred in this series. Four patients with mild infection and one patient with mild hemorrhage were the morbidity in the present study

Primary malignant lymphoma of the gastrointestinal tract: a clinicopathological study

Fifty two patients with primary lymphoma of the gastrointestinal tract collected over 6 years were studied. The mean age of patients was 48.16 +3.2 and the male to female ratio was 3.3:1. Twenty two lymphomas occurred in the stomach [42.31%]. Only one case of duodenal lymphoma was reported. Small intestinal lymphomas occurred in 18 patients [34.61%], while ileocaecal lymphomas were detected in 6 patients [11.54%] and colonic lymphoma in 6 patients [11.54%]. The commonest type of lymphoma encountered in this study was the intermediate grade [subtype:diffuse, large cell]. Low grade lymphoma occurred mainly in the stomach and intermediate grade lymphoma occurred mainly in the small intestine. Favourable prognostic factors included the female sex, gastric lymphoma, low grade lymphoma and the presence of reactive lymphoid hyperplasia

CT guided percutaneous drainage of hepatic abscess

Liver abscess is an infrequent surgical problem that carries high morbidity and mortality rates. The accepted method of treatment was surgical drainage and this has its potential difficulties and complications. With the advent of modern imaging techniques percutaneous drainage of hepatic abscess was introduced and popularized by many centres .We treated twelve patients with liver abscess by percutaneous indwelling catheter drainage using no. 12 or 14 F polyurethane abscess drainage tube with side holes. This was aided by the guide wire and image intensifier. We succeded to drain all patients with marked clinical improvement with no discernible complications and no mortality. Review of the literature and our experience suggest that percutaneous drainage should be the first line of management of liver abscess because of its low mortality and camplications and its high cure rate

Pneumatosis cystoides intestinalis: management of eight cases

Pneumatosis cystoides intestinalis is an uncommon condition characterised by the presence of cystic accumulation of gas in the submucosa or subserosa of the bowel. Though many aetiological factors are postulated, the exact pathogenesis is uncertain. The present work includes, in addition to a review of all aetiological factors, the management of 8 cases collected over five years. The clinical significance of the condition resides in the fact that familiarity with it can avoid unnecessary laparotomy [Thomson et al, 1977] Specific management by oxygen therapy and elemental diet are discussed in our reported cases