Diagnosis and management of small bowel and mesentery injury following blunt abdominal trauma in 12 cases

Over four years [April 2004 to December 2008] 12 patients with blunt small bowel and mesenteric injuries were treated at three hospitals dealing with trauma. Ten cases were victims of traffic accidents, of whom 70% wore seat belts. There were 11 small bowel injuries [4 full-thickness and 7 seromuscular] and 9 mesenteric injuries [3 with and 6 without a de-vascularized bowel segment]. All were managed initially following the Advanced Trauma Life Support [ATLS] guidelines. Emergency room ultrasound was positive for blood in 5/7 cases [71%] and CT scan in 2/4 [50%]. Diagnostic peritoneal lavage [DPL] was performed in one case and was positive for blood

Laparoscopic repair of abdominal ventral hernia: experience of 40 cases

The present study clarified experimentally the laparoscopic repair of forty abdominal human cases suffering abdominal ventral hernia. Most patients experience some sort of overweight and others were morbidly obese. The mean fascial defected size was 210 cm [2]. The operative time varied from one patient to another and most of the extra time was either in the lysis of the adhesions [between bowels or between bowel and abdominal wall] or in suturing the inadvertent enterotomies occurred during the dissection. The mean operative time was 170 minutes with a range of 140-210 minutes. The mean duration of hospital stay was 3.6 days with a range of 2 to 8 days. The outcome of the result was encouraging

Iatrogenic bile duct injuries: management of ten patients

The bile duct injuries rose from 0.1%-0.2% to 0.4%-0.7% from the era of open cholecystectomy to the era of laparoscopic cholecystectomy. Many classifications categorized the biliary tract injury, but none was universally accepted. In this study, 10 patients with iatrogenic major bile duct injuries were managed in Al Rahba General Hospital, UAE [April 2003 to December 2007]. They were 8 females and 2 males with a mean age of 46.5 years and a mean hospital stay of 19.4 days. Four patients were initially operated upon for laparoscopic cholecystectomy and six were initially operated on elsewhere. Intraoperative bile duct injury was discovered in only 2 cases, and in 8 patients, bile duct injury was discovered in the postoperative period. Roux en Y hepaticojejunostomy was the treatment of choice for 6 patients, and 4 patients was choledochodudenostomy in one patient, left hepaticojejunostomy in another, end to end anastomosis of common bile duct over a T tube in a third patient, and removal of a clip in the last patient. There was no mortality, but in the first year postoperative follow up, 2 developed cholangitis which responded to antibiotic

Surgical treatment of palmar hyperhidrosis: results of 60 cases using video assisted thoracoscopic sympathectomy technique

This study explained surgical treatment of sixty patients by video assisted thoracoscopic sympathectomy for palmar hyperhidrosis. Treatment was successful proved the life quality in a majority of patients

comparative study between laparoscopic versus open appendicectomy in men

In this study, 100 men were randomized to undergo either open or laparoscopic appendicectomy. Both groups were compared in terms of clinical parameters, duration of anesthesia, operative time, duration of ileus and length of hospital stay. The histologic confirmation of appendicitis was present in 92% in both groups. Laparoscopic appendectomy required significantly longer anesthetic and operating times compared with open appendectomy. No significant difference was noticed between laparoscopic and open appendectomy groups in the recovery of bowel function and in the length of hospital stay. The result showed no significant advantages of laparoscopic appendectomy over open appendectomy for the treatment of male patients with suspected appendicitis

Thoracoscopic sympathectomy for treatment of hyperhidrosis surgical experience and results of 30 cases

The thoracoscopic sympathectomy in treatment of primary palmar and axillary hyperhidrosis was performed on 30 patients complaining of hyperhidrosis admitted to El Demerdash University Hospital and Ain Shams University Specialised Hospital and the Saudi German Hospital between March 1999 and March 2001. The indication of surgery was primary palmar hyperhidrosis in 24 cases and combined palmar and axillary hyperhidrosis in 6 cases. 25 cases were males and 5 cases were females. The mean age in our sample was 25.7 +/- 4.05 years. There were no major complications in our series and 4 cases were complicated by intercostal vessels bleeding which were successfully controlled by cauterization during surgery and no one of them necessitated neither thoracotomy nor application of intercostal tubes. The patients were followed up for one year after operation and only one case had recurrence of palmar hyperhidrosis

Conservative management of hepatic trauma

In this study, the conservative management of 54 patients [37 males and 17 females with a mean age of 28 + 12.6 years] with liver trauma [40 cases of blunt trauma and 14 cases of penetrating injury] in the last six years was reviewed. Guided by clinical signs and CT scan, 28 patients were successfully managed without operation [22 with blunt injury and six with penetrating injury]. Most of the operatively managed patients after the failure of the conservative treatment were of grade IV and V liver injury. The complication rate was lower in the nonoperatively managed patients. Only two patients died in the operative group, but no mortality occurred in the nonoperative one. When surgery was done, the simplest maneuver to control bleeding was followed to reduce the morbidity and mortality rates. The clinical assessment and radiological monitoring may reduce the number of unnecessary laparotomies