Traumatic isolated perforation of lower oesophagus.

One of the rarest cases of non-iatrogenic oesophageal perforation is falling from height. We report a case of a 26 year old man with oesophageal perforation resulting from a fall of 12 meter height. A pneumomediastinum in the absence of a pneumothorax and contrast extravasation from the oesophagus on CT evoked a perforation of the aerodigestive tract. No other injuries were seen. A non-operative management was pursued with good outcomes.

Acute appendicitis in pregnancy: specific features of diagnosis and treatment.

INTRODUCTION: Acute appendicitis is the most frequent surgical emergency arising during pregnancy. Definitive diagnosis is often difficult. The therapeutic options remain the same, i.e. appendectomy. PATIENTS AND METHODS: We present a series of 29 pregnant women who underwent surgery for acute appendicitis over a period of 10 years. The mean age was 28.6 years. Mean gravidity was 1.75 and mean parity was 0.84. The average period of gestation was 18 weeks and 5 days since the last menses. Seven patients underwent surgery during the 1st trimester, 15 during the 2nd trimester, and seven during the 3rd trimester. Eighteen patients underwent appendectomy through a laparoscopic approach and 11 through a McBurney incision. RESULTS: The postoperative course was uncomplicated in 27 patients. Two patients miscarried in the week following surgery. CONCLUSIONS: Acute appendicitis puts both maternal and fetal prognosis at risk. Management should be prompt and undertaken by a multidisciplinary team approach. Morbidity and mortality are not negligible.