Case report of Brunner's gland hyperplasia: A rare "mimic" of malignant pathology.

Introduction: Brunner's gland hyperplasia is a rare, benign lesion of the duodenum. The symptomology can range from asymptomatic (as an incidental finding on endoscopy) to gastrointestinal obstruction or haemorrhage.

Case Presentation: We report a case of a 60-year-old man presenting with post-prandial vomiting and weight loss.

Splenic Artery Pseudoaneurysm Causing Massive Hematemesis 10 Years After Necrotizing Pancreatitis.

We report a case of a 54-year-old male presenting to a regional hospital with severe hematemesis and hemodynamic instability. His medical history was significant for a previous episode of alcoholic necrotizing pancreatitis and pseudocyst, requiring cystoenterostomy drainage and debridement 10 years prior. He underwent multiple gastroscopies and one emergency laparotomy which failed to definitively treat the bleeding.

Survival Rates for Patients With Barrett High-grade Dysplasia and Esophageal Adenocarcinoma With or Without Human Papillomavirus Infection.

Importance: High-risk human papillomavirus (HPV) has been associated with Barrett dysplasia and esophageal adenocarcinoma. Nevertheless, the prognostic significance of esophageal tumor HPV status is unknown.

Objective: To determine the association between HPV infection and related biomarkers in high-grade dysplasia or esophageal adenocarcinoma and survival.

Case report and operative management of gallbladder herniation.

Background: Incarcerated abdominal wall hernias may contain a variety of contents, but very rarely contains the gallbladder. This rare diagnosis is often not considered and, when diagnosed, has a different management approach. The experience of the small number of case reports have yet to be collected and summarised.

Effects of particle size, food, and capsule shell composition on the oral bioavailability of dabrafenib, a BRAF inhibitor, in patients with BRAF mutation-positive tumors.

Dabrafenib is a small-molecule inhibitor of BRAF kinase activity that is currently being developed for the treatment of BRAF V600 mutation-positive melanoma. This clinical, open-label, two-cohort (n = 14 per cohort), randomized study was designed to evaluate the effect of drug substance particle size, and food on the plasma pharmacokinetics of a single oral dose of dabrafenib in patients with BRAF V600 mutation-positive solid tumors. In addition, an exploratory cross-cohort comparison of the relative bioavailability of single-dose dabrafenib administered in gelatin and hydroxypropyl methylcellulose (HPMC) capsules was performed.

Surgery as primary prophylaxis from variceal bleeding in patients with extrahepatic portal venous obstruction.

Background And Aim: In patients with extrahepatic portal venous obstruction (EHO), death is usually due to variceal bleeding. This is more so in developing countries where there is a lack of tertiary health-care facilities and blood banks. Prophylactic operations in cirrhotics have been found to be deleterious.

Liver resection: a regional hospital experience.

Background: Liver resection is a significant operation usually limited to large metropolitan hospitals. Liver resections were first performed at the Launceston General Hospital (LGH), a regional centre (bed capacity 280), in May 2000. This is a summary of liver resection at LGH.

Traumatic Aorto-Mesenteric-Portal Fistula: Percutaneous management: Case Report.

Two months after a stab injury to the abdomen, a 35-year-old male presented at the All India Institute of Medical Sciences with haematemesis, shock and portal hypertension. Computed tomography of the abdomen and abdominal angiography revealed a large fistulous communication between an abdominal aortic pseudoaneurysm and a branch of the superior mesenteric vein. The fistula was occluded percutaneously, which allowed the patient to stabilise haemodynamically and, finally, to undergo a definitive surgical excision of the pseudoaneurysm and repair of the aortic defect.

Prophylactic surgery in non-cirrhotic portal fibrosis:is it worthwhile?

Background: In cirrhotic patients with portal hypertension prophylactic portasystemic shunts have been found to be ineffective as deaths from post-shunt liver failure exceed those from bleeding. However, in patients with non-cirrhotic portal hypertension, variceal bleeding rather than liver failure is the common cause of death. In developing countries shortage of tertiary health-care facilities and blood banks further increases mortality due to variceal bleed.

Outcome following emergency surgery for refractory severe ulcerative colitis in a tertiary care centre in India.

Background: Steroid-based intensive medical therapy for severe ulcerative colitis is successful in 60-70% of such patients. Patients with complications or those refractory to medical therapy require emergency colectomy for salvage. Little is known about the impact of timing of surgical intervention and surgical outcomes of such patients undergoing emergency surgery in India where the diagnosis is often delayed or missed in patients who are poor, malnourished and non-compliant to medical treatment.

Evaluation of Pringle maneuver during liver resection in a rat model of surgical obstructive jaundice.

Temporary portal triad clamping (Pringle maneuver) during liver resection reduces intraoperative blood loss. A normal liver can safely tolerate normothermic ischemia for up to 60 min. However, its safety in patients with surgical obstructive jaundice (SOJ) is not known.

Inflammatory fibroid polyp of the ileum causing intussusception.

Intussusception in adults is a rare cause for intestinal obstruction and is usually secondary to some lesion in the gastrointestinal tract GIT. We report a case of intestinal obstruction due to ileo-colic intussusception; an inflammatory fibroid polyp formed the leading edge of the intussusceptum, which is a rare polypoidal lesion of the GIT.

Association of extent and infection of pancreatic necrosis with organ failure and death in acute necrotizing pancreatitis.

Background & Aims: Organ failure is the usual cause of death in acute necrotizing pancreatitis. Our objective was to study whether the extent and infection of pancreatic necrosis correlate with organ failure and mortality.

Methods: All consecutive patients with acute pancreatitis were prospectively studied.

Gallbladder cancer in India: a dismal picture.

Background: Gallbladder cancer (GBC) is one of the most common gastrointestinal malignancies. The data regarding GBC are, however, limited.

Methods: Records of 634 patients with GBC over a 10-year period were examined with regard to the clinical presentation, investigative findings, treatment, operative findings and outcome.

Three-dimensional helical computed tomography cholangiography with minimum intensity projection in gallbladder carcinoma patients with obstructive jaundice: comparison with magnetic resonance cholangiography and percutaneous transhepatic cholangiography.

Objective: Computed tomography (CT) is traditionally used for evaluation and staging of gallbladder carcinoma (GC). However, in the subgroup of patients with obstructive jaundice, magnetic resonance cholangiography (MRC) is generally required to assess the level of biliary obstruction. The present study was undertaken to evaluate the diagnostic potential of three-dimensional helical CT cholangiography (3-D CTC) with minimum intensity projection (minIP), to determine the presence and level of biliary obstruction.

Gastroduodenal tuberculosis management guidelines, based on a large experience and a review of the literature.

Background: To review our experience of gastroduodenal tuberculosis before formulating management guidelines, we did a retrospective analysis at a large tertiary-care teaching institution in North India.

Method: We reviewed 23 consecutive cases of biopsy-proven gastroduodenal tuberculosis over a period of 15 years.

Results: The major presenting features were gastric outlet obstruction (61%) and upper gastrointestinal (uGI) bleeding (26%).

Appendiceal tumour--retrospective clinicopathological analysis.

Appendiceal tumours are rare and often discovered unexpectedly in an acute situation in which decision-making is difficult. We report the spectrum of appendiuar tumours seen in our institution over a period of more than 10 years, and discuss the clinicopathological behaviour, investigations, surgical procedures and outcomes in these patients. We have also reviewed the literature with regard to appendiceal tumours.

Spectrum of hemostatic derangements, in Budd-Chiari syndrome.

Background: Hemostatic abnormalities have been reported in various hepatocellular diseases. We evaluated the hemostatic functions in patients with Budd-Chiari syndrome.

Methods: Biochemical liver function tests, and measurement of prothrombin time, activated partial thromboplastin time, and plasma levels of anti-thrombin III (antigen) and activity of protein C were done in 36 patients with Budd-Chiari syndrome.