rare late complication of Meckel's diverticulum: diverticulitis induced parietal abscess presenting with multiple abdominal wall fecal fistulae. a case report and review of the literature

This paper presents a case report of 5 years old boy who presented with abdominal pain and fever to the pediatric reception room since four weeks. He was examined and investigated and the possibility of appendiciditis was excluded and a diagnosis of acute non specific mesenteric adenitis was coined. Follow-up medical treatment with antibiotics and conservative measures yielded a parietal abscess in the right iliac region. Simple incision drainage revealed pus and intestinal fecal content. A fecal fistula of appendicular origin was thought for and conservative management continued. However, investigation revealed a communication to the small intestines, and the multi-orifices draining fistulae caused a severe water and electrolyte imbalance with acidosis and emaciation. A decision at exploration revealed a complicated Meckel's diverticulitis, stuck to the abdominal wall and penetrating the muscular wall to end in an arborisation of fistulae in the right iliac fossa and right lumbar region. Resection anastomosis ensured a sound healing of the condition. The peritoneal cavity was exempted from any leak or peritonitis

Direct repair of spondylolysis or minimal degrees of spondylolisthesis by screw fixation and bone grafting

Twenty patients with chronic low back pain who were not responding to conservative measures for at least six months due to lumbar spondylolysis or grade-1 spondylolisthesis, with no evidence of spinal degeneration or nerve root compression. There ages ranged between 18 to 36 years old, the main age was 22.9 years. There were eleven females and nine males. All patients were treated with repair of the defect by screw fexation and bone grafting. The mean follow up period was 12 months [range, 18 - 40 months]. 80% of the patients obtained good to excellent clinical results, and 90% obtained solid fusion of the defect

Treatment of failed open reduction for congenital dislocation of the hip

Eighteen patients with involved twenty hips underwent unsuccessful open reduction for congenital dislocations of the hip due to an inadequate exposure and insufficient release of muscles and ligaments. All hips were reduced. The secondary open reduction was technically difficult. The follow up was 5 years [range 2 - 7 years]. In nine hips [45%] avascular necrosis was noted. Limb length discrepancies varied form 0 to 3 cmm

Lengthening of the lower limb by the Wagner method

A series of twenty-six patients who underwent twenty-eight lengthenings of the lower extremity using the Wagner's method is reviewed. There were eighteen femoral and ten tibial segments lengthened. The mean increase in length was 6.12 centimeters for patients with femoral lengthenings and 4.46 centimeters for those with tibial lengthenings. Particular emphasis is focussed on the complications which are frequent but with no significant effect of the end results

CT guided stereotactic biopsy of thalamic lesions using the Gauda frame

Advanced imaging techniques and increased sophistication of stereotactic instrumentation have enabled us to biopsy 12 thalamic lesions. Morbidity and mortality were nil. Accuracy was 100%. Two infections and two vascular lesions were encountered in this series, i.e. 1/3 of cases were non-tumoral. This emphasizes the importance of adequate tissue diagnosis of thalamic lesions using a safe, accurate, and inexpensive technique with the Gauda frame

Microsurgical repair of median and ulnar nerves

This study describes thirty-four cases of median and ulnar nerve injuries. Of these, ten cases had primary repair, eleven had delayed repair, seven were grafted and six patients in whom the lesion was in-continuity were treated by neurolysis. The average age was 32 years [range 14 to 45 years]. The average follow-up period was 4 years [range 1.5 to 5 years]. There were five excellent results, two after primary, one after graft and two after neurolysis. Seventeen were good, seven were fair and five were poor. The excellent results were found in younger aged patients

Open reduction and internal fixation of comminuted, intra-articular structures distal radius

Thirty patients with severely displaced intra-articular fractures of the distal end radius were treated by open reduction and internal fixation. All fractures were type C according to the classification of AO system. At mean follow-up of 2.5 years and according to MecBride and Lidstrom system of evaluation the results indicated that patient satisfaction was high 90% Functional and radiographic results were excellent or good in 90% and poor in 10% of the patients