ABSTRACT
Intestinal obstruction caused by an anomalous congenital band is very rare in adults and children. ACBs [Anomalous congenital band] are bands that have no identifiable embryological or acquired basis. We report an unusual case of intestinal obstruction in a 23 year old male patient who was found to have an ACB forming a loop around the jejunum [Fig-1] and causing closed loop obstruction. This band was arising from the treitz ligamentum and looping around the jejunum, ending at the root of mesentery. This band was in addition, causing compression of blood supply to the proximal jejunum
ABSTRACT
Laparoscopic cholecystectomy is one of the commonest surgical procedures carried out in the world today. Symptomatic gallstones needs surgery also patients with situs inversus. We discuss our case and problems encountered during surgery and how to solve them. A 50-year-old male presented with recurrent epigastric and left hypochondriac pain for the last year. A diagnosis of gallstones in a patient with situs inversus totalis was made following clinical examination and radiological investigation. Laparoscopic cholecystectomy was subsequently performed and the patient made an uneventful recovery. Situs inversus presenting with symptomatic gallstones is very rare. Laparoscopic cholecystectomy and other abdominal surgical operations are more difficult in patients with situs inversus hence they are rarely practiced
ABSTRACT
Different surgical techniques for pilonidal disease have been described in the literature. Limberg flap has low morbidity and recurrence rates. Fibrin sealant, a two-component tissue adhesive composed of fibrinogen and thrombin, has been used in a number of surgical procedures to achieve hemostasis and to seal tissues. The purpose of this study was to investigate the effect of fibrin sealant on the Limberg flap procedure. 132 male patients with pilonidal sinus who underwent Limberg flap operation were evaluated prospectively. The patients were assigned randomly into two groups [group 1; with suction drain, group 2; fibrin glue]. Seroma was encountered in 5 of 132 patients [3.78%]; Flap oedema occurred 4[6.06%] patients in group 1. Wound infection occurred in one patient [1.5%] in group 1. Most patients in group 2 were mobilized on the first postoperative day, and the median time to first mobilization was earlier in group 2 than in group 1 [1 [1-1] versus 2 [1-2] days respectively; P<0001]. The median duration of incapacity for work was 17 [15-20] days in group 1 and 8 [6-12] days in group 2 [P< 0.001]. Total wound dehiscence and flap necrosis did not occur in any patient. There has been no recurrence in any of the patients during the follow-up period. The mean time for complete healing of wound after rhomboid excision and Limberg flap plus fibrin sealant was 8.13 +/- 7.88 days [range 6-28 days]. This was markedly increased in group 1 patients [mean 22.08 +/- 8.59 days, and range 15-60][p < 0.001]. We recommend the use of fibrin sealant with Limberg flap technique. Our results suggest that drains may be avoided with fibrin sealant
Subject(s)
Humans , Male , Fibrin Tissue Adhesive , Postoperative Complications , Prospective StudiesABSTRACT
To report a case of signet ring cell adenoma of the thyroid which is an extremely rare thyroid lesion. A 25-year-old female patient presented with a goiter and dysphagia that had been present for the last 1 year before admission. Physical examination revealed a palpable solitary nodule in the right lobe of the thyroid. The ultrasonogram demonstrated multiple nodules among which the most remarkable one was 15 x 24 mm in size, in the right lobe of the thyroid. After surgical excision, the lesion was found to be consistent with signet ring cell adenoma characterized by the presence of round to oval signet ring cells with large cytoplasmic vacuoles and hyperchromatic eccentric nuclei. Intracytoplasmic thyroglobulin, periodic acid-Schiff [PAS] with and without diastase and combined Alcian-blue-PAS were all positive. Pathologists should keep this rare primary tumor of the thyroid in mind when examining thyroid lesions and should not confound it with metastatic signet ring cell carcinoma of the thyroid