Effect of Acute Surgical Stress on Serum Ghrelin Levels.

Background: Ghrelin is an appetite hormone that influences the gastrointestinal function and regulates energy metabolism. Growing evidence also suggests that this hormone plays a central role in immune modulation. Each surgical operation is followed by a series of inflammatory and metabolic changes that constitute the stress response.

The last place you would expect to find a gallstone.

The increasing use of laparoscopic cholecystectomy has led to an increased frequency of gallbladder perforation and subsequent gallstone spillage in the abdominal cavity. Occasionally unretrieved gallstones can cause infection, adhesions, and obstruction. Furthermore, spilt stones can cause erosion into adjacent organs and can migrate to distant sites, causing a variety of complications.

Sugammadex, a promising reversal drug. A review of clinical trials.

According to published data, sugammadex, rapidly reverses (2-5 min) shallow and profound NM block induced by rocuronium and vecuronium, without being connected with serious adverse events. It is accepted that in order to reverse shallow block, the suggested dose of sugammadex comes up to 2 mg/kg. Profound level of NM block demands 4 mg/kg in order to defy few responses at the post titanic count.

Struggling with a Gastric Volvulus Secondary to a Type IV Hiatal Hernia.

Type IV hiatal hernias are characterized by herniation of the stomach along with associated viscera such as the spleen, colon, small bowel, and pancreas through the esophageal hiatus. They are relatively rare, representing only about 5%-7% of all hernias, and can be associated with severe complications. We report a 71-year-old veteran wrestler who presented to our department with a type IV paraesophageal hernia containing a gastric volvulus and treated successfully with emergency operation.

Desmoid tumor of the supraclavicular region: a case report.

Desmoid tumors are rare, benign fibroblastic tumors that are locally infiltrative and can cause extensive morbidity by destruction of adjacent vital structures. Due to the rarity of these tumors, evidence regarding optimal treatment protocols is drawn from case reports and single-arm series with small patient numbers. We report a case of a patient with a desmoid tumor of the left supraclavicular region that was diagnosed and treated in our department and a review of the current literature.