Unusual ureteric duplication abnormality in a child with pelvoureteric junction obstruction.

A 5-year-old girl underwent an elective left pyeloplasty for pelvoureteric junction obstruction (PUJO). At laparoscopy, two ureters were seen to be draining a left duplex kidney, with a PUJO of the lower moiety. Interestingly, however, the upper moiety ureter was bifurcating to drain both upper and lower moiety as well.

Novel Use of Hydrodissection for the Insertion of Suprapubic Catheter Under Ultrasound Guidance.

Objective: To find a method of safely inserting a suprapubic catheter (SPC) under local anesthetic and under ultrasound guidance in patients who may not be fit for a general anesthetic but also are seen to have bowel overlying the anterior bladder wall which obscures a safe route to the bladder.

Materials And Methods: We used ultrasonography to visualize the bladder which was initially filled via the indwelling urethral catheter. A 22-gauge needle attached to a syringe filled with 30 mL of fluid (made up of 10 mL of 1% lidocaine plus 20 mL sterile water) was inserted transabdominally under ultrasound guidance into a space between the pubic symphysis and bowel.

Unusual presentation of a life-threatening intraperitoneal haemorrhage after elective inguinal hernia repair.

A 57-year-old man who was hypotensive at induction of anaesthesia was having intermittent episodes of hypotension after an uncomplicated and relatively bloodless open inguinal hernia repair of a large left-sided hernia . His hypotension was responsive to small fluid boluses. He did not show any tachycardia, had no abdominal pain, no signs of bruising or bleeding in his abdomen, flanks, or scrotum.