One stage resection of acute sigmoid volvulus

In a descriptive prospective study, 20 patients with sigmoid volvulus and two with ileosigmoid knotting had primary resection of the redundant sigmoid colon with an immediate anastomosis after intraoperative antegrade colonic irrigation. Tube caecostomy was established in the two patients who required resection of both small bowel and sigmoid colon and in a further five patients in whom the integrity of the colorectal anastomosis was suspected. There was no clinical anastomosis leak and no mortality in any of the patients. Superficial wound infection occurred in three patients. The duration of hospital stay ranged from 10 to 14 days. The result showed that the procedure was associated with an acceptable morbidity and a short hospital stay. Also, it suggested that the resection of acute sigmoid volvulus and primary anastomosis after antegrade intraoperative colonic lavage safely provided that the patient is reasonably fit

Role of laparoscopy in the evaluation of abdominal stab wounds

Laparoscopy was performed on 30 patients with stab wounds to the abdomen to identify those with peritoneal penetration. Diagnostic or therapeutic manoeuvres were not attempted, evidence of peritoneal penetration mandated exploratory laparotomy. All patients were haemodynamically stable, with no evidence of intraperitoneal injury by clinical assessment. Eighteen patients [60%] underwent negative laparoscopy and no intraperitoneal injury was subsequently detected. Most of the patients [89%] with negative laparoscopy had anterior stab wounds to the abdomen. Laparoscopy demonstrated peritoneal penetration in twelve patients [40%] and subsequent laparotomy detected intraperitoneal injuries in ten patients [83%]. A nontherapeutic laparotomy rate of 8% was recorded. A complication rate of 6% due to laparoscopy was detected, all cases were managed conservatively with no deaths. In haemodynamically stable patients with anterior stab wounds to the abdomen and no clinical evidence of intraperitoneal injury, laparoscopy effectively and safely detects those with peritoneal penetration

Evaluation of incidental laparoscopic appendectomy for acute right lower quadrant abdominal pain

The procedure of incidental laparoscopic appendectomy during diagnostic laparoscopy for acute right lower quadrant abdominal pain was evaluated in fifty patients over a three-year period. Twenty-five patients underwent diagnostic laparoscopy alone [group I], while the other twenty-five patients underwent diagnostic laparoscopy with incidental laparoscopic appendectomy [group II]. There was no difference in length of hospitalization or morbidity between the two groups. No mortality or intraoperative sepsis were recorded. Two patients required appendectomy eleven days and twenty days, respectively, after diagnostic laparoscopy for recurrent acute right lower quadrant abdominal pain. 8% of the resected appendices demonstrated acute inflammation upon pathologic review