ABSTRACT
We report a 16 year old boy with suspected appendicitis. Besides leucocytosis a roll was palpable in the right lower quadrant. The enema with water soluble contrast medium revealed an invagination. Intraoperatively, reduction was possible. The cause was an inverted Meckel's diverticulum. In this diverticulum we found a large perpendicular hyperplasiogenic gastric polyp as the cause of inversion and invagination.
Subject(s)
Choristoma/surgery , Ileal Diseases/surgery , Intussusception/surgery , Meckel Diverticulum/surgery , Polyps , Stomach Neoplasms , Adolescent , Choristoma/pathology , Humans , Ileal Diseases/pathology , Ileum/pathology , Ileum/surgery , Intussusception/pathology , Male , Meckel Diverticulum/pathologyABSTRACT
We report two patients who were administered to our hospital with an obstruction of the colon. 4 months ago one of the patients had suffered a penetrating wound with a knife in the upper left abdomen. The other patient was wounded by gunshot in the left thorax 50 years ago. The x-ray of the lung showed the ruptured diaphragm as a sharp line in the left thorax and the enema with contrast fluid revealed a stop at the left colonic flecture. In both cases the rupture of the diaphragm was closed via an abdominal approach, the inspection of the colon did not discover any defect. The postoperative course was uneventful. In contrast to other authors we believe that the delayed rupture of the diaphragm in connection with a colonic obstruction should be repaired by an abdominal access.
Subject(s)
Colonic Diseases/surgery , Diaphragm/injuries , Hernia, Diaphragmatic, Traumatic/surgery , Intestinal Obstruction/surgery , Wounds, Gunshot/surgery , Wounds, Stab/surgery , Adult , Aged , Colonic Diseases/diagnostic imaging , Diagnosis, Differential , Diaphragm/diagnostic imaging , Follow-Up Studies , Hernia, Diaphragmatic, Traumatic/diagnostic imaging , Humans , Intestinal Obstruction/diagnostic imaging , Male , Radiography , Suture Techniques , Wounds, Gunshot/diagnostic imaging , Wounds, Stab/diagnostic imagingABSTRACT
We report on 27 patients in whom a total of 28 augmented cutis plasties were performed to correct large hernias of the abdominal wall. After closure of the defect by cutis plasty an absorbable mesh is sutured at the fascia 2-3 cm away from the edge of the fascial defect. Postoperatively, 2 subcutaneous seromas had to be punctured. No wound infections were observed. After a first procedure (n = 14) the recurrence rate was 7%, while after correction of recurrent hernias (n = 14) there were 2 failures (14%). Augmentation by the mesh means that high initial stability of the abdominal wall is achieved, allowing transformation of the cutis into a strong fibrous tissue.
