ABSTRACT
Background: the liver is the organ most commonly injured during abdominal trauma. The use of anatomic resection for liver trauma is advocated a conservative surgical approach when operative intervention is required
Objective: to assess the results of anatomic liver resection for severe liver trauma
Patients and Methods: during the period 2003 to 2005, among 100 patients with abdominal trauma and different types of liver injury admitted at El-Minia University Hospital, 20 patients had severe liver injuries and underwent anatomical hepatic resection. All patients had grade IV injury. Pringle maneuver was applied to control hemorrhage. The resections performed included, bi-segmentectomy of segment 6 and segment 7 [n= 8], left lateral segment resection [n = 6], right lobectomy [n = 4] and segmental resection of segment 6 [n= 2]
Results: the mortality rate was 5%, as one patient died postoperatively due to major hepatic vein injury, while the morbidity rate was 25%. Postoperatively, there was a statistically significant improvement in hemodynamic status. One month after surgery, there was statistically non significant minimal change in liver functions
Conclusion: an anatomic resection of the liver for trauma in appropriate situations may be a useful, safe procedure today
ABSTRACT
Background: Hirschsprung's disease [HSCR] is the most common congenital malformation of the enteric nervous system. Duhamel's Operation [DO] is among the accepted procedures for the treatment of Hirschsprung's disease. One stage pull-through without colostomy has been reported. The procedure is currently performed using circular staplers, which afford equally good results
Objective: To evaluate efficacy and feasability of one-stage Duhamel's procedure using circular stapler for treatment Hirschsprung's disease
Patients and methods: Over a period or 2 years, 22 child patients have been treated by one stage Duhamel's operation using circular stapler after good preparation of the colon. Clinical presentation, other anomalies, operative time, intraoperative complications, bowel habits, continence scoring, postoperative complications and mean of body weight were reported within 2-ycars follow-up period
Results: The mean or age was 2.6 years [range: 1-4 years]. There was post-operative wound infection in one case, no infection at the anastomotic site, or pelvic collection. Motion was passed within 24 to 48 hours and the patients discharge from the hospital within 7 to 14 days postoperative. There were no intraoperative complications. All postoperative complications were mild to moderate in severity and improved after medical treatment. Bowel function was significantly improved after surgery. There was a significant increase in the modified Kelly's continence scoring after operation [p-value <0.001]
Conclusion: One-stage Duhamel's operation with circular stapler has a great satisfactory results in infancy and early childhood