Massive bleeding from left colonic arteriovenous malformation in a young patient with ventricular septal defect

Arteriovenous malformation of the gut is well known to have been an important bleeding focus in past ages. We report a young Korean male patient, who had been known to have ventricular septal defect, presenting massive lower gastrointestinal bleeding from an arteriovenous malformation involving a long segment of the left colon. Angiographic, gross and histologic findings are presented and the literature is reviewed.

Inguinal Herniorrhaphy in Patient with Cirrhosis of Liver and Ascites

The records of 15 cirrhotic patients with ascites and groin hernias(14 inguinal and one femoral) were retrospectively reviewed. Fifteen patients underwent repair of their groin hernias. All patients were performed herniorrhaphies electively. No major and one minor(wound infection) postoperative complications occurred. There were no perioperative deaths or ascitic leak. All patients were available for follow-up. In this group, 7 deaths occurred after herniorrhaphy, 5 of 7 were Child's Class B and 2 of 7 were Child's Class C. In this same group of patients, mean alive duration were 25.7 month(4-89 months). From this retrospective study, it appears that serious complications from groin hernias in cirrhotics are not common, and elective repair can usually await control of ascites. Additionally, for appropriately selected patients with ascites, elective inguinal hernia repair can be performed safely, with an acceptable rate of recurrence.