ABSTRACT
Teratoma affecting the large bowel is extremely rare. Thus far, only two cases have been reported in the English-language literature. Herein the authors describe what they believe is the third such case.
Subject(s)
Colonic Neoplasms/diagnostic imaging , Teratoma/diagnostic imaging , Child, Preschool , Colon/diagnostic imaging , Colon/pathology , Colonic Neoplasms/pathology , Female , Humans , Remission, Spontaneous , Teratoma/pathology , Tomography, X-Ray ComputedABSTRACT
Strangulation of the penis caused by a coil of hair is uncommon. It can produce varying grades of injury that may result in a urethral fistula or even gangrene of the glans. Therefore it is important to be aware of this condition so that the strangulating hair can be removed and treatment instituted. The authors describe 15 boys who presented with hair coil strangulation of the penis. Their age range was 5 to 11 years. All were previously circumcised. Three boys had a superficial injury, and 11 had a more severe injury that resulted in a urethral fistula. One boy presented with gangrene of his glans penis, which resulted in autoamputation. One-stage repair was performed in 10 boys. The first three had recurrence of the fistula, and hence the technique was modified for the remaining seven patients. The latter technique proved simple and satisfactory.
Subject(s)
Penis/injuries , Urethral Diseases/surgery , Urinary Fistula/surgery , Child , Child, Preschool , Gangrene , Hair , Humans , Male , Penis/pathology , Penis/surgery , Surgical Procedures, Operative/methods , Urethral Diseases/etiology , Urinary Fistula/etiologyABSTRACT
The usefulness of selective transplenic decompression of oesophageal varices by distal splenorenal shunt and splenocaval shunt was evaluated in the control of gastrointestinal haemorrhage in patients with portal hypertension of varied aetiology. (Decompression was successful in 69 out of 78 cases.) It was shown that it is superior to total portosystemic shunts, as the incidence of encephalopathy was very low compared with the data from our series of portocaval shunts. The operative mortality has been progressively lowered and has now reached levels comparable with portocaval shunt. Distal splenorenal shunt when performed as an emergency procedure to arrest bleeding has limited usefulness but when performed as an elective or prophylactic procedure its results are comparable with those of portocaval shunt without the untoward complications such as encephalopathy. A modified selective decompression of varices has been described in which the distal end of the splenic vein is anastomosed to the inferior vena cava. Though no long term follow-up studies are available, we believe that this shunt is likely to prove superior to distal splenorenal shunt as it has both the advantages of the distal splenoral and the haemodynamic advantage of end-to-side portocaval shunt. We conclude that in patients with portal hypertension of varied aetiology, who have not had a haemorrhagic episode but in whom varices have been demonstrated or who have had one episode of haemorrhage from varices, the splenocaval shunt when feasible or the distal splenorenal shunt offers the optimal method of management at present in India.
