RESUMO
An infected material in the gastrosplenic area after laparoscopic sleeve gastrectomy [LSG] due to hematoma or staple line leak has the potential to spread of the bacterial content to the liver which can result in pyogenic liver abscess. Presently described is a thirty-seven-year-old female patient with unilocular pyogenic liver abscess two weeks after LSG. The abscess resolved by Ultrasound guided percutaneous drainage plus intravenous antibiotic treatment. Review of the literature regarding 3 other cases with liver abscess after LSG is also presented
RESUMO
Objective: To compare Ligation under Vision [LUV] with Ferguson Hemorrhoidectomy [FH] in patients with Grade II, III and IV hemorrhoidal diseases according to their postoperative outcomes
Methods: Between July 2008 and August 2014, 155 patients underwent FH and 120 patients LUV, in Sakarya University Teaching and Research Hospital. Our retrospective analysis focuses on postoperative complications, postoperative pain and rate of recurrence. In LUV procedure, submucosal tissue of the hemorrhoidal pile base was transfixed using absorbable sutures under direct vision through anoscope in the Jackknife position
Results: In a mean postoperative follow-up period of 51.76 +/- 22.3 months; ectropion, anal fissure, and anal incontinence were the most frequent complications. The overall complication rate was significantly less after LUV than FH, [6.7% vs. 14.2%, P=0.047]. The complication rate and need for a second or third surgery did not significantly differ between the two procedures with the increase in affected quadrants [P>0.05]. The visual analog scale [VAS] at 24 hours was similar in both groups [P=0.267]
Conclusions: LUV is a safe, and practical procedure with similar outcomes compared to FH. LUV may be a better choice than excisional hemorrhoidectomies when three or four quadrants of the anal canal are involved with hemorrhoids as this reduces mucosal defect related possible complications such as ectropion and anal stenosis