ABSTRACT
The spleen is well fixed below the left side of the diaphragm. Wandering spleen is a rare condition of unknown pathogenesis. The wandering spleen is most often localized in the lower abdomen or pelvis. The diagnosis may be difficult if wandering spleen is not suspected. Often a wandering spleen can be palpated in the lower abdomen. In the rare cases of torsion of the splenic vascular pedicle, wandering spleen becomes symptomatic, and splenectomy should be performed. We report a case of a 20-year-old female treated with splenectomy because of torsion of the vascular pedicle.
Subject(s)
Spleen/abnormalities , Splenic Diseases/diagnosis , Adult , Female , Humans , Spleen/pathology , Splenectomy , Splenic Diseases/surgery , Torsion AbnormalityABSTRACT
The incidence of bile duct injury after laparoscopic cholecystectomy has been reduced to 0.6%. One factor contributing to such injuries is misidentification of the bile duct anatomy. During laparoscopic cholecystectomy the surgeon should follow the criteria for dissection of the triangle of Calot and dealing with bleeding. Immediate reconstruction over a T-tube may be possible, or a baby-feeding tube should be inserted into the proximal part of the bile duct and the patient should be transferred to a center with experience in bile duct reconstruction.
Subject(s)
Cholecystectomy, Laparoscopic/adverse effects , Intraoperative Complications , Postoperative Complications , Cholecystectomy, Laparoscopic/methods , Common Bile Duct/injuries , Common Bile Duct/surgery , Hepatic Duct, Common/injuries , Hepatic Duct, Common/surgery , Humans , Intraoperative Complications/diagnosis , Intraoperative Complications/surgery , Intraoperative Complications/therapy , Postoperative Complications/diagnosis , Postoperative Complications/surgery , Postoperative Complications/therapy , Practice Guidelines as Topic , Plastic Surgery ProceduresABSTRACT
INTRODUCTION: Radio frequency ablation (RFA) of malignant tumours is a new and promising treatment modality. The aim of this study was to evaluate the method in patients with non-resectable liver tumours. MATERIAL AND METHODS: RFA was performed under the guidance of ultrasonography and general anaesthesia in 37 patients from December 1998 to November 2001. Six patients had primary liver cancers, and 31 metastases from other cancer, often colorectal cancer. RESULTS: Eight patients could not be evaluated because of the short follow-up time. Twenty-four of 29 patients (83%) achieved a complete tumour response. Twelve patients (41%) are alive after 3-28 (median 16) months, without recurrence. Twelve patients (41%) are alive after 1-34 (median 14) months, with recurrence. Five patients (14%) died after 4-26 (median 11) months, because of recurrence in the liver and/or other organs. Four patients had minor complications and one a major complication. There was no postoperative mortality. DISCUSSION: RFA can be offered to patients with non-resectable liver tumours when it is technically possible. The treatment can be performed with few complications, requires only a short hospital stay, and is cheaper than other treatments. Prolonged survival is attained in 40-50% cent of the patients.
