ABSTRACT
A metastatic deposit from renal cell carcinoma into the jejunal wall is a rare phenomenon. Among the frequent modes of presentation, bleeding, obstruction and unexplained anaemia are commonly seen. In addition to the conventional contrast studies and computerized tomography (CT), Capsule endoscopy is a useful diagnostic tool. Factors responsible for resistant behaviour of jejunal wall are still not clear, however when it happens it is really a diagnostic challenge. We are reporting this rare case of solitary jejunal metastasis from renal cell carcinoma.
Subject(s)
Carcinoma, Renal Cell/pathology , Jejunal Neoplasms/secondary , Aged , Female , Humans , Jejunal Neoplasms/diagnosis , Jejunal Neoplasms/pathologyABSTRACT
In the contemporary practice, surgery is the only potentially curative treatment available for gastric cancer. However, there is no consensus on the extent of surgical resection. Advantages of D2 gastrectomy in terms of morbidity, mortality, local recurrence and survival are confirmed in Japanese as well as some European trials. In our hospital, all patients with operable gastric cancer are treated with D2 gastrectomy along with splenectomy and distal pancreatectomy followed by jejunal pouch reconstruction. The study was undertaken to evaluate our practice in terms of postoperative morbidity and mortality. All the patients who had total gastrectomy for gastric carcinoma from January 1995 to December 2000 were included in the study. During this 6-year period, 33 patients underwent potentially curative D2 gastrectomy. Postoperative morbidity and mortality were 18 and 9%, respectively. There were no anastomotic leaks. Three (9%) patients developed dysphasia, of which two (6%) had anastomotic stricture requiring dilatation. We feel D2 gastrectomy with splenectomy and distal pancreatectomy when performed electively is a safe procedure in experienced hands. Oesophago-jejunal anastomosis can be safely performed using circular stapler.
Subject(s)
Gastrectomy/mortality , Stomach Neoplasms/surgery , Aged , Female , Hospital Mortality , Humans , Male , Postoperative Complications/mortality , Prospective Studies , Stomach Neoplasms/mortalitySubject(s)
Catheterization/adverse effects , Duodenum , Gastric Outlet Obstruction/diagnosis , Gastroscopy/adverse effects , Intestinal Perforation/etiology , Lacerations/etiology , Liver/injuries , Catheterization/methods , Emergencies , Female , Follow-Up Studies , Gastric Outlet Obstruction/pathology , Gastroscopy/methods , Humans , Intestinal Perforation/surgery , Lacerations/surgery , Laparotomy/methods , Middle Aged , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
In many centres laparoscopic cholecystectomy has become the procedure of choice for symptomatic gallbladder stones. By comparison with conventional cholecystectomy it appears to be associated with minimal morbidity, shorter hospital stay, earlier return to work and a better cosmetic result. The present study reviews the results of the first 50 laparoscopic cholecystectomies performed at Altnagelvin Area Hospital.
Subject(s)
Cholecystectomy/methods , Cholelithiasis/surgery , Laparoscopy , Adult , Aged , Female , Hospitals, District , Hospitals, General , Humans , Length of Stay , Male , Middle Aged , Northern Ireland , Postoperative Care , Postoperative ComplicationsABSTRACT
Spontaneous cholecystocutaneous fistula is now a clinical rarity due to improvements in the treatment of biliary tract diseases. This case report describes a 67-year-old woman in whom subcutaneous herniation of a pathologically dilated gall-bladder was followed by spontaneous discharge of pus and mucus with formation of a cholecystocutaneous fistula. The use of serial computed tomography examinations enabled this unusual diagnosis to be made.
Subject(s)
Biliary Fistula/etiology , Fistula/etiology , Gallbladder Diseases/etiology , Hernia, Ventral/complications , Skin Diseases/etiology , Aged , Female , Gallbladder Diseases/diagnostic imaging , Hernia, Ventral/diagnostic imaging , Humans , Tomography, X-Ray ComputedABSTRACT
The injuries sustained by skateboard riders vary from minor cuts and abrasions to fractures. This report describes a unique injury sustained by a young skateboard rider who was impaled on a metal rod. Literature review of over 1,254 skateboard injuries did not reveal any other instances of penetrating abdominal trauma.
