A new technique of postoperative pancreatico gastric enterocutaneous fistula repair using de-tubularised afferent loop.

Postoperative fistula involving upper gastrointestinal tract surgery is a rare but troublesome occurrence. Reoperation on these patients is challenging and needs to be individualised. Various methods are described including primary closure, bypass procedures, serosal patch repair and Roux-en-Y repair. We present a new technique of repair using afferent loop that provided a vascularized bowel segment, which used in an anatomical fashion for closure of fistula.

Hydatid disease: an unusual breast lump.

Hydatid disease of the breast is rare, but it should be included under differential diagnosis of a breast lump especially in endemic areas of this disease. Fine needle aspiration cytology can provide a safe pre-operative diagnosis, although mammogram, ultrasonography of breast, magnetic resonance imaging and serological tests like Casoni's test can also be done. Complete excision of the cyst without spillage can be a curative procedure for primary hydatid cyst of the breast. It is important to explore other common sites like liver and lung by means of ultrasonography and chest x-ray and treat accordingly. Here in this report, a lady of 27 years old presented with a painless lump of the left breast. Fine needle aspiration cytology was inconclusive. Lumpectomy was done. Histopathological examination confirmed it to be a case of hydatid disease involving the left breast.