value of splenic vicryl mesh repair in cases of rupture spleen

Twenty-three patients [15 males and 8 females] with rupture spleen; grade II in 3 cases [13.04%], grade IIl in 12 cases [52.17%] and grade IV in 8 cases [34.78%] had been managed with splenic preservation and vicryl mesh application. Splenic salvage with mesh was done in 20 cases [86.96%] while in the remaining 3 cases [13.04%] partial splenectomy was done followed by mesh application. The vicryl mesh was successful in controlling splenic bleeding in all cases [100%]. However, re-exploration was performed in two cases for causes other than bleeding. The first case was explored due to peritonitis from disrupted gastric tear and splenectomy was performed. The second case was explored due to small bowel gangrene and resection anastomosis was done with preservation of the mesh and the patient was discharged after 10 days. One patient died in the first post-operative day suffering from cerebral laceration. One week after the operation duplex scanning demonstrated normal flow in the splenic vessels in the surviving 22 cases and IgG, IgA and IgM were found to be within normal limits. The application of splenic mesh for preservation of injured spleen is a safe and reliable method for splenic salvage and maintenance of splenic function

result of treatment of 165 Egyptian patients with bleeding oesophageal varices

This retrospective study presents the fate of 165 patients with endoscopically proven bleeding oesophageal varices [O.V.]. One hundred and three patient [62.4%] were admitted with acute bleeding while 62 patients [37.6%] had definite history of bleeding. Thirteen patients out of 103 patients [12.6%] with acute bleeding died of uncontrollable haemorrhage during early resuscitative measures. Bleeding stopped spontaneously in 49 patients [47.6%]. Forty one patients had persistent bleeding and were treated with intravenous vasopressin. Bleeding stopped in 12 patients, 6 patients died, and 23 patients had continued bleeding and Sengestaken Blakemore tamponade method was adopted for them. Eleven patients died and 12 patients survived

Primary closure in the treatment of acute abscess [a controlled clinical trial]

One hundred consecutive patients of different ages and sexes presented to Port Fouad Hospital were studied.All suffered from acute subcutaneous abscess at different sites which required drainage under general anesthesia. They were randomly allocated into two equal groups: Group I [50 patients] who were treated by incision, curettage and primary closure without antibiotics and group II [50 patients] who were treated by conventional method [drainage and repeated dressing]. The wound healing was faster in group I [average 8.8 days compared with 24.1 days], the hospital visits were less [average 4.2 visits compared with 11.7 visits] and the mean time off work was also shorter in group I [4.4 days compared with 13.3 days]

Observations on the occurrence of deep vein thrombosis in patients with superficial thrombophlebitis of the leg

Thirty-four patients presenting with superficial thrombophlebitis of the lower limbs were studied clinically and radiologically by means of venously to find out the possible incidence of DVT among them. In this study, the incidence of DVT in patients with varicosities was rare. However, patients suffering form STH without varicosities DVT was high [38.5%] enough to recommend venously for such patients especially in susceptible groups