Transanal protrusion of a ventriculoperitoneal shunt catheter

A two years old boy presented with a transanal protrusion of the ventriculoperitoneal [VP] shunt catheter. A VP shunt was inserted when the boy was six-month-old for congenital hydrocephalus. He was active and neurologically normal, with no signs of meningitis and peritoneal irritation. During laparotomy, the tube was seen entering the sigmoid colon, so the tube was cut at the point where it entered the sigmoid colon. The distal end of the protruding tube was pulled out from the anus. The sigmoid colon was repaired, and a delayed shunt revision was completed. The patient was discharged without abdominal and neurological deterioration

Distal illeal perforation secondary to ingested foreign bodies

A 22-year-old man was admitted with abdominal pain, nausea and vomiting secondary to ingestion of multiple foreign bodies. He was found to be in increasing distress with an increase in abdominal pain and distention and no passage of foreign bodies. Patient underwent a laparotomy. Foreign bodies removed from perforated distal ileum included 8 big size [10 cm] plastic clothes pegs, a 10 cm pencil, couple of stones, a 10 cm wood nail, nail scissors and a small size battery. In case of foreign body ingestion, especially in mentally-ill patients, the patient should be carefully examined because of the potential risk of obstruction and bowel perforation, more so, if the foreign body is a battery which can puncture causing corrosive injury as well

effects of N-acetylcysteine and vitamin C on liver and pulmonary tissue damage in rats following bile duct ligation

To evaluate the effects of N-acetylcysteine NAC and vitamin C on pulmonary histological alterations in bile duct-ligated [BDL] rats. The current study was conducted in the Department of Pediatric Surgery, Medical School of Abant Izzet Baysal University, Bolu, Turkey between May 2007 and July 2007. Thirty-five males Sprague-Dawley rats, weighing 210-240 grams, were used. Group 1 rats [n=7] underwent only laparotomy. Group 2 rats [n=7] were subjected to BDL. Group 3 rats [n=7] were subjected to BDL and given vitamin C. Group 4 rats [n=7] were subjected to BDL and given NAC. Group 5 rats [n=7] were subjected to BDL and received NAC plus vitamin C. At the end of the 3 week period, biochemical and histological evaluations were processed. Total bilirubin values were decreased in group 5 compared to group 2, 3, and 4. Group 2 showed massive interstitial infiltration with inflammatory cells. Interstitial edema, focal cuboidal metaplasias of alveolar lining cells, and severely damaged pulmonary architecture were noted. Treatment of rats with NAC and vitamin C produced a significant reduction in the histopathological score compared to groups 2, 3, and 4. The combination of NAC and vitamin C reduced lung histological alterations in BDL rats with afforded by each drug individually

Continuous infusion of small-volume fluid resuscitation in the treatment of combined uncontrolled hemorrhagic shock and head injury

To determine the effect of continuous limited fluid resuscitation on the hemodynamic response and survival in rats in a model of uncontrolled hemorrhage shock due to Massive Splenic Injury [MSI] and Head Injury [HI]. An experimental study. Dicle University Animal Research Laboratory, Turkey, between January and February 2005. Seventy Sprague-Dawley rats were used in this study. Group 1 rats [n=10] was sham-operated. In group 2 [n=10], only Massive Splenic Injury [MSI] was performed and untreated. In group 3 [n=10], only head injury [HI] was performed and untreated. In group 4 [n=10], HI and MSI were performed and were untreated. In group 5 [n=10], HI and MSI were performed and 15 minutes later treated with 7.5% NaCl. In group 6 [n=10], HI and MSI were performed, and rats were treated with Ringer's Lactate [RL] solution. In group 7 [n=10], HI and MSI were performed, rats were treated with 0.9% NaCl. In groups 2, 4, 5, 6 and 7 midline incision was reopened and splenectomy was performed at 45 minutes. In group 4 rats, Mean Arterial Pressure [MAP] was decreased from 104 +/- 6.1 mmHg to 75 +/- 19.5 mmHg at 15 minutes; heart rate decreased from 357 +/- 24.9 beats/min to 321 +/- 62.1 beats/min and hematocrit decreased from 46 +/- 1.3% to 43 +/- 2.5% [p<0.01]. Similar early changes in MAP, heart rate and hematocrit were observed in groups 5, 6, and 7, at 15 minutes. At 45,60 and 120 minutes, in fluid resuscitated rats [group 5,6,7] MAP, heart rate and hematocrit values were measured higher than group 2 and 4 [p<0.01 for all]. At 120 min. in group 6, hematocrit was higher than group 4, 5 and 7, in group 6, total blood loss after splenectomy was calculated at 20 +/- 2.4% of blood volume and was the best value compared to other fluid resuscitated group 5 and 7 [28% and 27% of blood volume] [p<0.01]. Mortality was lower in all fluid resuscitated groups when compared to group 3 and 4 [p< 0.05]. The median survival time was again higher in fluid resuscitated groups. Continuous infusion of 7.5% NaCl, RL and 0.9% NaCl following uncontrolled hemorrhagic shock with massive splenic injury and combined head injury resulted in better survival and RL did not increase abdominal bleeding before splenectomy was performed