Endoscopic assessment of effacement of balloon waist during pneumatic dilatation of primary achalasia cardia under topical anesthesia

Balloon dilatation of Primary Achalasia Cardia [PAC] is usually performed under antegrade endoscopic guidance, with conscious sedation. The main goats of this prospective study were to assess the safety and efficacy of pneumatic dilatation without conscious sedation and to determine the endoscopic signs of effacement of the balloon "waist". Pneumatic dilatation was successfully performed as outdoor procedure without conscious sedation in patients [n= 25; mean age 42.56 years] with endoscopic and radiologic diagnosis of PAC. Immediate relief of symptoms was observed in 23 [92%] cases. Effacement of the balloon "waist" under endoscopic vision was appreciated in all cases in the present study. Common complications of pneumatic dilatation were chest pain in all [100%] subjects and mild local bleeding in 17 [68%] patients. There was no cancellation of procedure. Re-dilatation was required in 2 [8%] cases. The duration of follow-up was from 6 weeks to 23 months. Pneumatic dilatation of PAC can be safely performed as same day procedure, without conscious sedation. Obliteration of the balloon "waist" can be readily determined by antegrade "endoscopic assessment of stretch on the lower oesophageal sphincter [EASL]"

Mesenteric lipoma leading to small gut strangulation and short gut syndrome

A rare case of mesenteric lipoma was presented to us as acute abdomen. His abdominal x-ray showed dilated small gut. Ultrasonography of abdomen revealed dilated small gut loops and minimal amount of free fluid in the peritoneal cavity. On exploration, most of the small gut was gangrenous and tightly twisted twice around its mesentery that contained a lump which was confirmed as lipoma on histopathology

Transverse ectopia of the testis: a case report

A case of transverse ectopia of the testis in a man of 30 years is presented. The patient was admitted for a right inguinal herniorraphy and the finding of ectopic testis was accidental

Evaluation of various methods of repairing inguinal hernia; a prospective study

Between January 1980 to December 1989 inclusive, 590 cases of inguinal hernia were evaluated in the general surgical departments of Federal Government Services Hospital and Pakistan Institute of Medical Sciences, Islamabad. The purpose of this study was to compare the various methods of repairing hernia and to see the results of surgery and the complications thereof. There were 575 male and 15 female patients with mean age of 38 years. Duration of symptoms was highly variable. Right sided inguinal hernia was more common as compared to the left [3:2]. Surgery was performed in all cases including classical Bassini's repair with and without Tanner slide, nylon darn and Shouldice repair