ABSTRACT
Prostatic abscesses are a rare complication of acute prostatitis, and an uncommon clinical entity in the antibiotic era. Despite their rarity, untreated abscesses still remain potentially life-threatening, and require formal drainage to permit resolution. Here in, we report the MRI findings in 73 - years old man who presented with severe dysurea of two weeks duration . He was found to have multiple prostatic abscesses which was surgically drained
ABSTRACT
Introduction: In decompensated liver diseases with umbilical hernia [U.H.], when the ascites is refractory, the abdomen becomes very tense, that may lead to rupture of the U.H. After repair of the ruptured U.H., the ascitic fluid accumulates very rapidly, clue to salt and water retention produced by metabolic response to surgery added to the original pathology of portal hypertension and prolonged use of diuretics that lead to severe salt depletion, which in turn leads to low response to diuretic therapy. In the post-operative period the patient feels much discomfort, with the possibility of early disruption of the hernial repair
Aim of the Work: To assess the impact of insertion of abdominal drain after repair of ruptured umbilical hernia in ascitic patients
Materials and Methods: Twenty patients with chronic decompensated liver disease presented with ruptured U.H., were divided randomly into two groups tell each: Group 1: Repair of the hernia and insertion of tube drain in the peritoneal cavity for one week. Group 2: Repair of the hernia without abdominal drain
Results: Male to female ratio was 4:1. All the studied cases were of Child grade C, all of them had hypoalbuminaemia [mean value= 1.97 G/%]. The mean platelets count was 64,350 /cu mm., and the mean total leucocytic count was 10,735/cu mm. In the drained group the amount of ascitic fluid drained was decreasing with its lowest value just before the removal of the drain and before the start of the diuretic therapy. The mean hospital slay in the drained group was 10.7 days, and in the non-drained group was 5 days. Three patients developed wound infection one in the drained group and 2 in the non-drained group. Follow up for 12 months revealed recurrence of the U.H. in two cases from the non-drained group, with no recurrence in the draied group
Conclusion: insertion of a drain after repair of rupture U.H. relieves most of the post-operative abdominal discomfort, gives some rest to the already exhausted kidneys, minimize the possibility of wound infection and minimizes the possibility of early hernial recurrence
ABSTRACT
Background: The liver is the main site where most of glucose metabolic processes take place. It is suspected that partial hepatectomy will alter the glucose homeostasis, so it is mandatory to study the effect of partial hepatectomy on the glucose metabolism. Introduction: the liver exerts multiple complex metabolic functions. Partial hepatectomy, reduces the functioning liver cell mass. The body responds to surgery both locally and generally. The general one includes endocrinal and metabolic response
Aim of the Work: To determine the effect of partial hepatectomy on the glucose metabolism, by performing Glucose tolerance curve
Materials and Methods: 32 rats were included in this work, divided into 4 groups, 8 rats per each [5 were subjected to actual resection and 3 were subjected to sham operation]. First group: glucose tolerance curve [GTC] was done 24 hours after hepatectomy, 2[nd] group the GTC was done 48 hours after hepatectomy, 3[rd] group the GTC was done 72 hours after hepatectomy, and 4[th] group the GTC was done 96 hours after hepatectomy. Two blood samples were taken, pre-operative and post-operative, for determination of blood sugar and liver enzymes. For determination of the GTC, blood glucose was determined 4 times: at [0] time fasting sample, then [1/2 an hour] after an oral glucose meal then at [1 1/2 hours] and at [2 1/2 hours]
Results: There was weight loss in the post-operative period in various groups, that was minimal [8 grams] in the 1[st] group, and maximal [13 grams] in the 4[th] group. The resected segments varied from 30% to 60% of the whole liver mass. The mean liver weight was 3.67% of the whole body weight. In the P.O. period there was elevation of the ALT and AST, which was greater in the 1[st] group and least in the 4[th] group. There was low grade hyperglycemia, and the blood glucose level failed to return to baseline, 2 1/2 hours after the oral meal, in all groups. There were slight changes in the level of the B. sugar between various groups and between the individuals of each group, but not to the significant level
Conclusion: There was postoperative glucose intolerance manifested by low grade hyperglycemia in the early postoperative period with mild diabetic curve despite the reduced functional liver cell mass
ABSTRACT
Introduction: Hyaluronic acid [HA] is produced mainly in fibroblasts specially in synovial tissue, and part of the produced HA enters the general circulation via the lymphatic system and is rapidly cleared and degraded almost exclusively in the liver, by a very efficient and specific receptor mechanism in sinusoidal endothelial cells [SEC]. The serum level of HA increases if its production is increased [inflammation of synovial membranes] or its clearance is decreased [impaired liver function]
Aim of the work: To determine the value of serum level of Hyaluronic acid in assessment of chronic liver diseases and Hepatocellular carcinoma
Patients and Methods: This study included 90 patients, divided into 3 groups: - Group 1: 60 patients had chronic liver diseases with various etiology with no malignancy. -Group 2: 20 patients had HCC. -Group 3: 10 patients with no liver disease as a control group. The group of chronic liver disease was subdivided into 3 subgroups, according to Child-Pugh [CP] classification, [A, B, and C]. Serum Hyaluronic acid [HA] was determined for all the studied cases at the time of examination and once more for HCC group, 2 weeks after surgical resection or tumor ablation
Results: Serum[S]. hyaluronic acid was significantly higher in the group of chronic liver disease and its subgroups [Child-Pugh A, B and C subgroups] than in the control group. There was direct proportion between the serum level of HA and the severity of the chronic liver disease. Pre-operatively, the serum level of HA in HCC cases was increased significantly, as compared to the control group. Postoperatively, the s. level of HA was decreased but insignificantly
Conclusion: The serum Hyaluronic acid [HA] concentration reflects the extent of liver fibrosis and severity of cirrhosis. HA could be used as a non-invasive marker for assessment of chronic liver disease, where its serum level was seen to correlate positively with the advancement of the liver disease. Its value in HCC cases was insignificant, where it has no diagnostic or prognostic value, and the serum level of HA in these cases reflects the underlying liver disease