Coexistent hepatic and pulmonary epitheloid hemangioendothelioma.

Epitheloid hemangioendothelioma (EHE) is a rare neoplasm of vascular origin known to arise in soft tissue, liver and lung. We describe a case of coexistent hepatic and pulmonary epitheloid hemangioendothelioma, proven on autopsy, and review the histological and radiological features of epitheloid hemangioendothelioma. The coexistence of hepatic with pulmonary EHE has been reported in only a few cases. Large confluent masses, peripheral location with capsular retraction, hypertrophy of uninvolved liver, invasion of portal and hepatic veins, enhancing margins and delayed enhancement and dense calcification are the typical features which provide a clue to diagnosis of hepatic EHE. In patients with both hepatic and pulmonary EHE it is difficult to say whether the tumor arose primarily in the lung or liver, or began simultaneously in both organs.

Pancreas-sparing duodenectomy for trauma.

The application of pancreas sparing duodenectomy (PSD) in extensive duodenal trauma has not been fully explored. We report 3 caes of duodenal trauma in whom PSD was performed successfully and with good results.

Primary angiosarcoma of the spleen--a case report.

Primary splenic angiosarcomas are rare neoplasms. They have aggressive behavior that frequently present with hematological abnormalities and metastatic disease. The diagnosis can only be made at surgery. Prognosis of this disease is poor. We present a rare case of primary splenic angiosarcoma with metastases in liver.

Spleen preserving distal pancreatectomy for blunt abdominal trauma--a case report.

The case of a 22-year-old male who underwent spleen preserving distal pancreatectomy (SPDP) for pancreatic trauma is briefly reported. SPDP was performed by preserving the splenic vessels to maintain a reliable splenic blood flow post-operatively. Although technically demanding, this procedure can be performed safely and easily in the emergency, and avoids splenectomy-related problems in the post-operative period.

Repair of iatrogenic oesophageal perforation using a vascularized diaphragmatic flap.

The use of a pedicle patch of diaphragm to reinforce the primary closure of a large, iatrogenic oesophageal perforation in a patient of achalasia cardia is reported.

Mechanical bowel obstruction: the Chandigarh experience.

Intestinal obstruction is a fairly common surgical emergency in India, but there is little data available regarding the spectrum of intestinal obstruction in India, or its related complications. This paper represents a retrospective review of 97 patients who underwent surgery for intestinal obstruction at Government Medical College and Hospital, Chandigarh, India, over four years (1997-2000). The case files of all these patients were reviewed and analysed for patient particulars, pre-operative clinical examination and investigations, intraoperative findings, final diagnosis, post-operative morbidity, and mortality. The mean age of our patients was 39.46 years, with an overall male to female ratio of 2.46:1. Most of the patients were in the age group of 17 to 60 years (62.89%). A total of 107 causes for the obstruction could be identified at surgery, with intra-abdominal adhesions and bands (27.10%) being the commonest followed by obstructed herniae (22.43%). Strangulation was present in 21 patients at the time of surgery. This group of patients had a significantly higher post-operative morbidity than patients with simple obstruction, although no statistically significant difference was seen in between the mortality rates in these two groups.

A case of sigmoid lipoma presenting with intussusception.

Colonic lipomas are rare, benign tumours that rarely produce symptoms. Presented here is a case where a sigmoid lipoma acted as lead point to produce intussusception.