Management of laparoscopic-related bowel injuries.

BACKGROUND: Bowel injury is an uncommon but severely hazardous complication of various laparoscopic procedures. METHODS: Twelve cases of bowel injuries complicating different laparoscopic procedures were diagnosed or received at Ain Shams University and Menofia University hospitals over the last 3 years. The mechanism of injury was analyzed, the diagnostic methods and surgical management scrutinized, and the prognosis studied. RESULTS: The injuries were attributed to the inadvertant introduction of Veress needles or sharp-tipped trocars or forcible undue dissection. Failure of pneumoperitoneum was implicated in two cases. Faulty judgment of the extent and site of adhesions contributed to the damage in two cases. In four cases, the duodenum was injured. The colon was perforated in six cases, and the small bowel sustained damage in two cases. Three of the patients died, all of duodenal injury. The other nine patients survived by virtue of diagnosis and proper operative management. CONCLUSION: Every measure should be taken to avoid the occurrence of bowel injury during laparoscopy. Intraoperative or early postoperative diagnosis and proper management of laparoscopic-induced bowel injuries can minimize morbidity and mortality and yield a better prognosis.

The possibility of lice allergy among Egyptian patients with asthmatic bronchitis.

The aim of this work was to study the possibility of lice allergy among Egyptian asthmatic patients. Sixty asthmatic patients were examined by prick skin tests as compared to ten normal subjects as controls using HD, CD, MP, MM, CH, DH, F, W, and two lice extracts: one was prepared from head and salivary glands and the second was prepared from the abdomen. Precipitin tests with the 2 lice extracts were done using the double immunodiffusion test for both patients and controls. Out of the sixty asthmatic patients only six gave positive skin reactions to both lice extracts. All the controls gave negative skin reactions. There was statistically insignificant difference between both groups and there was no difference between reactivity to different parts of lice body used as skin test antigens at the dilutions 1/10 and 1/100. On the other hand, 25 reacted to H.D., of whom two patients gave positive skin reactions to lice extracts. Twelve asthmatic patients (20%) gave positive skin reactions to M.M. of whom 2 patients (16.7%) gave positive skin reactions to lice extracts. Thirteen asthmatic patients reacted to C.D. of whom 3 cases gave positive skin reactions to lice extracts. These results were statistically insignificant. The precipitin tests were negative in both asthmatic and control groups. It was concluded that the lice allergens have insignificant role in asthmatic bronchitis.