Gastric epithelioid leiomyoma causing intraperitoneal hemorrhage.

We have presented a rare and interesting case of intraperitoneal hemorrhage due to an epithelioid leiomyoma, the second such case in the literature. Epithelioid leiomyomas are usually clinically insignificant. When hemorrhage occurs, it is usually intraluminal and rarely intraperitoneal. Ultrasonography, upper gastrointestinal series, and computerized tomography are important tools in the diagnosis of complicated gastric tumors. Wedge resection is generally recommended, but subtotal gastrectomy should be considered if malignancy is suspected.

Choledochoscopy in surgery for choledocholithiasis. Six year experience in 380 consecutive patients.

Choledochoscopy is a definite advance in biliary surgery as it simplifies the operative procedure and decreases the retained stone rate. Easy to perform without special training, its use is cost-effective. Therefore, we agree with Kappes et al [10] recommendation that routine intraoperative biliary endoscopy be performed in all patients undergoing common bile duct exploration.

Serosal integrity and intestinal adhesions.

PIP: The study, carried out on 50 mongrel dogs, was designed to determine the necessity for surgical reperitonealization of bowel as well as the effect of raw intestinal surfaces on adhesion formation. Results showed that serosal denudation of the terminal ileum healed spontaneously in 70% of the dogs when denudation involved less that the entire antimesenteric border. Incisions to the submucosa healed spontaneously without adhesions in all cases, while dogs which had their incisions sutured formed dense adhesions in the area on the silk suture.^ieng