ABSTRACT
This paper outlines the recommendations from the Association of Colon & Rectal Surgeons of India (ACRSI) practice guidelines for the management of haemorrhoids-2016. It includes diagnosis and management of haemorrhoids including dietary, non-surgical, and surgical techniques. These guidelines are intended for the use of general practitioners, general surgeons, colorectal surgeons, and gastrointestinal surgeons in India.
ABSTRACT
Interventional internal drainage of the biliary tract has become an established procedure for both the temporary and definitive treatment of biliary obstruction due to malignant or benign disease. Biliary stent migration and stent fracture are known but rare complications. A 50-year-old man presented with acute onset pain in the abdomen and vomiting. He had undergone hepaticojejunostomy following a bile duct injury during open cholecystectomy 13 years before he presented at our institution. Subsequently, he developed a benign biliary stricture at the anastomotic site, which was stented transhepatically by a metallic stent. CT of his abdomen showed a fractured stent segment obstructing the jejunum with a localized perforation. Herein, we discuss his presentation and course of management, and review the factors influencing stent migration and fracture and the potential options for stent retrieval. The patient needed surgical intervention to retrieve the migrated fragment of metal stent and to resect the perforated jejunal segment. The role of endoscopic self-expanding metal stents for benign biliary disease remains controversial. A migrated stent that has become symptomatic should be removed endoscopically in early and accessible cases and surgically when endoscopic measures fail or when complicated by obstruction or perforation.
Subject(s)
Cholestasis/surgery , Intestinal Obstruction/etiology , Intestinal Perforation/etiology , Jejunal Diseases/etiology , Stents/adverse effects , Cholestasis/diagnosis , Cholestasis/etiology , Equipment Failure , Humans , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Intestinal Perforation/diagnosis , Intestinal Perforation/surgery , Jejunal Diseases/diagnosis , Jejunal Diseases/surgery , Male , Middle AgedABSTRACT
Pelviureteric junction obstruction of the kidneys secondary to crossing renal vessels is a known entity. We report a 26-year-old woman with obstruction secondary to portosystemic collaterals; she was incidentally detected to have extrahepatic portal vein obstruction.
Subject(s)
Hydronephrosis/etiology , Kidney Pelvis/blood supply , Portal System/abnormalities , Renal Veins/abnormalities , Ureteral Obstruction/complications , Adult , Angiography/methods , Collateral Circulation/physiology , Female , Follow-Up Studies , Humans , Hydronephrosis/diagnostic imaging , Tomography, Spiral Computed/methods , Ultrasonography, Doppler , Ureteral Obstruction/diagnostic imagingABSTRACT
Computed tomography (CT) angiography is fast replacing the diagnostic conventional angiography and digital subtraction angiography. A case of a type V portal vein anomaly, which was diagnosed by Doppler ultrasound and confirmed on CT angiography, is presented. Demonstration of the portal vein branching pattern and its anomalies assumed importance and significance after split liver and segmental transplantation techniques were developed. There are 5 variations of portal vein branching that have been described.
Subject(s)
Angiography/methods , Portal Vein/abnormalities , Portal Vein/diagnostic imaging , Tomography, X-Ray Computed , Adult , Humans , MaleABSTRACT
We report the case of a paraduodenal hernia treated by reduction of the hernia and closure of the hernial orifice.