RESUMO
Major hepatectomies consider one of the most challenging procedure and did not become commonplace until the dramatic improvement in periopertive care in the 1980s. Review the outcome of liver resection performed recently in Gastroenterology and Hepatology Teaching Hospital. From June 2008 to March 2011, nine major anatomic hepatic resection was performed. Enucleation, Non-anatomic or wedge resection was excluded from this study. There were 4 men, 4 women and one child. Age range between 5-43 years median age 40 years. Nine major resection was done this include; extended right hepatectomy 1 patient, right hepatectomy 2 patients, left hepatectomy 3patients, left lateral lobectomy 2 patients, right anterior sectionectomy one patient. The inflow pedicle was controlled either by extrahepatic approach in 6 patients or intrahepatic pedicle ligation by vascular stapler in 3 patients. Post-operative hospitalization was 3-16 days, median 8 days. There were no mortality. Two patients developed bile leak in form of biloma which was treated by percutaneous drainage under ultrasound for 2weeks. Two patients develop intra-operative hypothermia that led to stop the operation for one hour until warming of the patient. Major liver resection can be performed in our hospital with acceptable morbidity rate
RESUMO
Gastric volvulus is a twisting of the stomach on itself more than 180 degree, which is either an organo-axial or mesentero-axial volvulus. This case report presents a rare and probably the first reported chronic secondary organo-axial gastric volvulus caused by a large epigastric hernia. Gastric volvulus is worth to be added to the index of differential diagnosis in the presentation of chronic gastric symptoms of epigastric hernia