Biliary fascioliasis - A rare differential diagnosis of biliary obstruction.

Fascioliasis is a zoonotic disease caused by Fasciola hepatica or F. gigantica. There are two phases of Fasciola infection. In the acute phase, the patient has a wide spectrum of clinical manifestations while the later phase of infection is usually related to inflammatory changes in the bile duct and the mechanical effects of the worm, which can lead to biliary obstruction. The presence of Fasciola inside the biliary system has rarely been reported in the literature. In this report, we presented a case of bile duct obstruction in a 36-year-old male patient undergoing cholecystectomy for gallstones and with a history of worsening jaundice for one month. Extensive laboratory testing failed to clarify the cause of jaundice. Three living liver flukes were subsequently retrieved from the right hepatic duct and later confirmed as F. gigantica by morphology and internal transcribed spacer (ITS2) sequence analysis.

Hepatectomy with Takasaki's Technique Using SonaStar Ultrasonic Aspiration System: An Experience from 58 Cases.

OBJECTIVE: This study aims to explore the short-term results of hepatectomy with Takasaki's technique using Sonastar ultrasonic aspiration system. MATERIALS AND METHODS: We retrospectively examined data of 58 patients who underwent hepatectomy with Takasaki's technique using Sonastar ultrasonic aspiration system at Hue Central Hospital from 01/2018 to 02/2021. RESULTS: The mean age was 60.7 ± 10.5 years (25-80) and the male/female ratio was 6:1. Patients with solitary tumor accounted for 79%; 68.4% had tumor size greater than 5 cm. Pringle maneuver was used in 57.9%, while selective right or left Glissonean pedicle occlusion was used in 69.0% and 32.8%, respectively. Final transection surface reinforcement was achieved by Surgicel and BioGlue in 78.9% and 21.5% of cases, respectively. Major liver resection accounted for 73.7%. The mean parenchymal transection time was 50 (45-110) minutes, while mean total operative time was 125 (90-280) minutes. Mean operative blood loss was 250 (150-650) mL. Mean post-operative hospital stay was 8 days (7-23). Post-operative complication rate was 15.9% and mortality rate was 1.7%. CONCLUSION: Hepatectomy using Takasaki technique with Sonastar ultrasonic aspiration system is safe, effective, allowing an anatomical resection with sufficient safety margin and resulting in low complication rates (liver failure, biliary leakage) and good survival outcomes.

Perforated Acute Appendicitis in a Six-Day-Old Neonate: A Rare Differential Diagnosis of Neonatal Peritonitis.

Acute appendicitis is a rare diagnosis of acute abdomen in neonates which is associated with high mortality due to late diagnosis. Here, we presented a case of acute neonatal appendicitis in a 6-year-old full-term infant with Down syndrome and pulmonary atresia with ventricular septal defect. The patient underwent surgery and postoperative critical care. However, he died on postoperative day 5 due to worsening sepsis and decompensated hemodynamic instability.