ABSTRACT
This is a report of a case of endometrioma of the abdominal wall in a 34-year-old woman who had a two-year history of lower abdominal pain. The physical examination revealed an ill defined mass with tenderness. Computed tomography showed an enhancing isodense mass at the midline-right rectus abdominis muscle. The patient was treated with a mesh grafting repair following a wide radical resection with a 1 cm margin. There were no postoperative complications. The histological examination confirmed endometriosis. The patient is now on regular follow-up and doing well without any recurrence, five months after her operation.
ABSTRACT
Objective: To contribute our five years of experience of laparoscopic cholecystectomy in Songklanagarind Hospital and find out the risk factors of prolonged length of hospital stay.Design: A retrospective study.Materials and methods: A review of the hospital database of all the patients who underwent laparoscopic cholecystectomy between January 2001 and December 2005.Results: A total of 539 laparoscopic cholecystectomies were performed; the conversion rate was 23.19%. In the cases of successful laparoscopic surgery; patients the mean time for hospital stay was 5.23 days. Surgical site infection occurred in 9.67% of the cases and prophylactic antibiotics were used for 85.27% of the patients. Significantly, surgical wound infection was associated with the type of drain used and also obesity (p = 0.03, p \< 0.001). Local injections of marcaine did not reduce the volume/quantity of narcotic used (p=0.236), and was found to very slightly increase the incidence of wound infection (p = 0.215). Prophylactic postoperative nausea and vomiting (PONV) did not reduce the incidence of severe PONV and medication used (p = 0.109). One patient had a common bile duct injury (0.28%).Conclusions: Laparoscopic cholecystectomy is a safe and feasible procedure. We have tried to improve the patient outcome through moving to a day care laparoscopic cholecystectomy surgical option.
ABSTRACT
The incidence of corrosive substance ingestion is high in southern Thailand. Gastrointestinal tract injury caused by caustic ingestion can be severe and result in high mortality. There are several factors that can affect the degree and extent of damage. In the acute stage, perforation and necrosis of the upper gastrointestinal tract may occur. Endoscopy should be attempted early to assess the extent of the damage. Management is mainly resuscitation, detection and correction of the complications. Potential long-term complications include esophageal stricture, antral stenosis and development of esophageal carcinoma. Esophageal strictures, which occur more commonly, correlate to the degree of injury and are managed by dilatation or surgical correction. This article summarizes the management of caustic injury and treatment options.