Urgent laparoscopic surgery for cholecystitis and appendicitis during pregnancy

To study the safety and outcome of laparoscopic surgery in pregnancy in non obstetrical abdominal emergencies in a tertiary referral teaching hospital in Rawalpindi, Pakistan. Prospective observational study. This study was carried out at Fauji Foundation Hospital, Rawalpindi, Pakistan from March 2004 till Feb 2010. All the pregnant females presenting with acute abdominal pain requiring surgical intervention underwent laparoscopic surgery by experienced laparoscopic surgeons. Total of twelve laparoscopic procedures were performed in pregnancy for nonobstetrical emergencies at variable gestational ages representing all the three trimesters. Outcome of the procedures, complications, hospital stay and follow up was recorded and compared with the relevant literature on open and laparoscopic surgery in similar situations. All the patients had successful laparoscopic procedures with no complications to pregnancy. One patient developed laparoscopic port site infection and another patient had a brief episode of pulmonary edema. All the patients were followed till the end of their pregnancies and delivered healthy babies. For pregnant females presenting with acute abdominal conditions laparoscopic surgery is safe, feasible and the preferred option provided adequate laparoscopic facilities and expertise exists

Large urethral calculi with periurethral abscess and fistulae

We are reporting a case of 60 years old male who had a suprapubic catheter already passed for urinary retention. He had an abscess over penile shaft. Operative findings revealed two large urethral calculi in penile shaft. Calculi were removed via urethral fistulae, formed spontaneously over a period of 30 days

Colonic injuries: is primary repair a safe option?

This study was conducted at Mayo Hospital, Lahore from April 2004 to May 2005 to compare the results of primary repair and exteriorization in cases of large gut injuries. 80 patients, presenting in emergency between Jan. 2004 and December 2005, were selected out of which 63 were males and 17 were females. Colonic injuries were divided into five categories and were dealt accordingly. All colonic injuries presenting to emergency in study period except. Injuries requiring ileocolic anastomosis, repair and proximal fecal diversion and distal colonic injuries requiring Hartmann's procedure

role of magnetic resonance cholangiopancreatography [MRCP] in obstructive jaundice

To evaluate the diagnostic value of MRCP in studying the sites and cause of obstructive jaundice in comparison with other imaging modalities at the Department of Radiology, Aga Khan University Hospital, from January 1999 to May 2001. Forty nine consecutive patients included 19 men and 30 women, suspected of obstructive jaundice. Patients underwent ultrasound [n=49], CT [n=11], ERCP [n=25] and biliary surgery [n=17]. Final diagnosis was established by surgical exploration, endoscopic sphincterectomy, cytology and clinical follow up. Of the 49 patients 17 had choledocholithiasis. Twenty five patients had malignant strictures, out of which 11 had non-specific malignant strictures, 7 had pancreatic carcinoma, 3 had Klatskin tumors, 3 had periampullary carcinoma and 1 had gallbladder carcinoma. Six patients had benign strictures and 1 patient had choledochal cyst. Overall, MRCP was sensitive [88%] and specific [96.8%] in detecting choledocholithiasis. MRCP sensitivity and specificity in detecting benign main bile duct stricture was equal to 83.3% and 97.6% respectively, and 92% and 100% for malignant stricture. Our prospective study confirms that MRCP, a noninvasive and well tolerated imaging technique is of value in the diagnosis of obstructive jaundice