Subtotal gastrectomy for a carcinoma of stomach without post operative chemotherapy

A 47-year old female was complaining of upper abdominal pain. Ultrasound revealed chronic calculus cholecystitis. OGD showed a large tumor in the gastric antrum. Biopsy indicated adenocarcinoma. On exploration it was observed that the tumor in the distal part of the stomach had invaded the serosa with multiple node enlargement. Cholecystectomy with subtotal gastrectomy and roux-en-y gastro jujenostomy and excision of the greater and lesser omentum and supragastric and infragastric lymph node excision were undertaken. The postoperative period was uneventful. No postoperative chemotherapy was given and the patient is free of distant metastasis and local recurrence after six years

Missed bullet: a case report

A 27-year old Iraqi male patient with no known chronic illnesses presented with pain in the lower abdomen associated with frequency of micturition and blood in the urine with bouts of fever of about six years' duration. He gave a history that when he was 10years old during the war in Basrah, Iraq 1991,while he was playing football in the street one of his friends pointed out a red stain on the side of his T-Shirt. Removal of the shirt showed a small bloody wound over the left side of his back. No surgery was done at that time and the wound was treated by cleaning and dressing. Physical examination was normal apart from suprapubic tenderness. Blood test normal. Urine analysis-red blood cell 6-8/H.P.F. KUB: full size bullet in the pelvis. CT-Scan: Intravesical metallic foreign body [bullet] with right lateral wall linear calcification likely related to the site of entrance. Operation was done under spinal anesthesia and the bullet extracted from the urinary bladder. The post-operative period was uneventful and the patient was discharged after two days in a good condition and the stitches removed after eight days