Treatment of persistent complex seroma postventral incisional hernia repair by capsulectomy and scarification using argon beam coagulator.

We present a case of chronic complex seroma following ventral incisional hernia repair with a mesh. The patient was managed initially conservatively by observation followed by multiple percutaneous aspirations and tube drainage. After 6 months of conservative management, the patient remained symptomatic and the surgical scar showed evidence of ulceration, skin necrosis and sinus formation.

Endoscopic removal of an incidentally discovered intrauterine contraceptive device eroding into the rectum.

Intrauterine contraceptive device (IUCD) is a common birth control method. It is safe but can be associated with serious complications including migration into the peritoneal cavity and penetration into other intra-abdominal and pelvic viscera; most commonly the rectosigmoid colon. Different retrieval methods including endoscopy, laparoscopy or open abdominal surgery have been described.

Boerhaave's Syndrome: Delayed Management Using Over-the-Scope Clip.

BACKGROUND The diagnosis of Boerhaave's syndrome is often missed or delayed. This subsequently leads to a high mortality rate, which could be greatly reduced if treatment is instituted early, within 24 hours of perforation. Treatment ranges from conservative management to operative intervention depending on the time of presentation and the patient's clinical condition.

Evidence-based surgery: The obstacles and solutions.

Surgeons are often accused of lagging behind their medical colleagues in embracing evidence based medicine and utilizing new research tools to conducting high quality randomized controlled trials. Although there has been a noticeable improvement in the quantity and quality of high quality studies in surgical journals, the widespread practice of evidence based surgery is still poor. Unlike evidence based medicine, the practice of evidence based surgery is hampered by inherent problems and obstacles.

A case of sigmoid colon duplication in an adult woman.

Colonic duplication is a rare congenital anomaly that is often diagnosed in childhood, but may go unrecognised until adulthood. It often presents with chronic abdominal pain and constipation, and the preoperative diagnosis may be difficult. We present a case of sigmoid duplication in a 33-year-old Indonesian woman who presented with right-sided colicky abdominal pain and vomiting.

Iatrogenic oesophageal transection during laparoscopic sleeve gastrectomy.

Laparoscopic sleeve gastrectomy has been hailed as an easy and safe procedure when compared with other bariatric operations. However, it may be associated with well-recognised early complications such as leaks and bleeding, as well as late ones such as stenosis and weight regain. Iatrogenic complete oesophageal transection has never been reported before as a complication.

A rare approach to entero-atmospheric fistula.

Patient: Female, 60 FINAL DIAGNOSIS: Recurrent incisional hernia Symptoms: -

Medication: - Clinical Procedure: Limited ileo-cecal resection Specialty: Surgery.

Objective: Diagnostic/therapeutic accidents.

Background: Iatrogenic entero-atmospheric fistula is devastating and its management is extremely difficult because it is often associated with fluid and electrolyte disturbances, nutritional problems, and life-threatening sepsis.

Colonic lymphoma presenting acutely with perforated colo-splenic fistula.

Introduction: Primary colonic lymphoma is rare. It comprises less than 1% of large bowel malignancies. Affected patients often present with non-specific vague symptoms with subsequent delays in diagnosis and management.

Portal vein thrombosis after restorative proctocolectomy for familial adenomatous polyposis and sigmoid cancer.

Postoperative portal vein thrombosis (PVT) is rare, but has been described after various open as well as minimal access abdominal operations, especially splenectomy and colorectal surgical procedures. We report the case of a 39-year-old female who underwent restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis with sigmoid cancer. She presented 14 days later with vague upper abdominal pain, nausea, vomiting and high output stoma.

Appendiceal mass: is interval appendicectomy "something of the past"?

The need for interval appendicectomy (I.A) after successful conservative management of appendiceal mass has recently been questioned. Furthermore, emergency appendicectomy for appendiceal mass is increasingly performed with equal success and safety to that performed in non-mass forming acute appendicitis.

Traumatic pancreatic fistula with sinistral portal hypertension: Surgical management.

Combined ductal and vascular injuries are awesome complications of pancreatic injury. We report on a 29-year-old male unrestrained driver who sustained a blunt abdominal injury from the steering wheel in a high velocity head-on car collision. He developed a pancreatic fistula, portosplenic venous thrombosis and sinistral portal hypertension as a result of complete duct disruption at the pancreatic neck.

Controversy of hand-assisted laparoscopic colorectal surgery.

Laparoscopically assisted colorectal procedures are time-consuming and technically demanding and hence have a long steep learning curve. In the technical demand, surgeons need to handle a long mobile organ, the colon, and have to operate on multiple abdominal quadrants, most of the time with the need to secure multiple mesenteric vessels. Therefore, a new surgical innovation called hand-assisted laparoscopic surgery (HALS) was introduced in the mid 1990s as a useful alternative to totally laparoscopic procedures.

Pitfalls of diagnostic laparoscopy in abdominal tuberculosis.

Background: Diagnostic laparoscopy currently is emerging as an important tool in the diagnostic armamentarium for abdominal tuberculosis (TB). However, the laparoscopic view may be deceiving even to the most experienced eyes, and it is not uncommon for TB to be diagnosed erroneously before the final histologic confirmation is received.

Methods: A retrospective review of 20 diagnostic laparoscopies was conducted.