Diffuse Type Pancreatic Ductal Adenocarcinoma: The Linitis Plastica Type of the Pancreas.

Pancreatic malignant tumors are diverse and characterized by aggressive nature with high mortality rates. Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic malignant tumors and accounts for approximately 90% of pancreatic malignancies. A subtype of PDAC, diffuse type PDAC (DTP), is a very rare and underreported tumor, known for its aggressive traits.

Clinical Audit of Papillary Thyroid Cancer Reporting Format in Sultan Qaboos University Hospital in Oman.

Null.

Intractable Postoperative Pancreatic Fistula: Undefined Type of Pancreatic Fistula Managed by Puestow-Like Procedure.

Pancreatoduodenectomy (PD) is a very complex and highly challenging operation for surgeons worldwide. It is the surgical procedure of choice for the management of benign and malignant diseases of the periampullary region. Although mortality rate following this complicated surgery has fallen to 1-3%, morbidity rate following PD remains high, with almost 30-40% of patients developing at least one complication.

Fulminant Emphysematous Pancreatitis: Diagnosis Time Counts.

Emphysematous pancreatitis (EP), a severe form of necrotizing infection of the pancreas, is an extremely rare medical emergency with high rates of mortality. It is characterized by intraparenchymal pancreatic or peri-pancreatic air due to either monomicrobial or polymicrobial infection with gas-forming bacteria or due to entero-pancreatic fistula. EP is classified according to timing from disease onset when air bubble signs were detected on computed tomography (CT) scan, as early onset (within 2 weeks from disease onset) or late (more than 2 weeks from disease onset).

Adult Primary Retroperitoneal Lymphangioma: Updated Facts.

Lymphangioma is a rare, benign tumor of the lymphatic system. It is believed to be a congenital malformation, when part of the lymphatic channels fail to connect to the main lymphatic system. Lymphangioma is a tumor of the pediatric age, with 50% of patients presenting at birth.

Gastrocolic Fistula: An Extraordinary Gastrointestinal Fistula.

Gastrocolic (GC) fistula, a rare gastrointestinal pathological condition, is defined as an abnormal connection between the stomach and the colon. Mostly, it involves the greater curvature of the stomach and the transverse part of the colon. Its precise incidence rate is unknown and largely differs between western and eastern nations.

Primary Recurrent Common Bile Duct Stones: Timing of Surgical Intervention.

Cholelithiasis (gallstones) is a very common medical problem worldwide, with 5-30% of patients demonstrating a combined condition of cholelithiasis and choledocholithiasis (common bile duct stones (CBDS)). CBDS are usually classified as primary or secondary stones. Primary CBDS are defined as stones detected 2 years or more following cholecystectomy, while secondary stones, the most common type, usually migrate from the gallbladder to the bile ducts.

Kluri Anomaly: Newly Introduced Pancreatic Duct Anomaly.

Anomalies of the pancreas organ, especially congenital anomalies, are very uncommon, and can involve the pancreatic ductal as well as the pancreatic extra-ductal systems. While these anomalies usually present as an incidental radiological finding during adulthood, sometimes, they can present as recurrent upper abdominal pain as a presentation of recurrent episodes of acute idiopathic pancreatitis. Thus, these anomalies should be regarded in the differential diagnosis list, as a cause, for recurrent idiopathic pancreatitis, especially in the adult age group of patients.

Retroperitoneal Liposarcoma: The Giant Type.

Retroperitoneal tumors (RPTs) are very rare tumors that arise in the large space of the retroperitoneum. About two-third of these tumors are malignant, of which soft tissue sarcoma (STS) is the most common and comprises almost one-third of malignant RPTs. Twenty to thirty percent of RPTs are benign.

Giant Retroperitoneal Liposarcoma: Correlation Between Size and Risk for Recurrence.

Soft tissue sarcomas (STSs) are rare tumors that represent almost 1% of adult malignant tumors. The annual incidence rate for such tumors is 2 - 5/100,000 population. The most common type of STS in adults is liposarcoma, which represents 15-20% of adult STSs.

Postpancreatoduodenectomy Hemorrhage: Association between the Causes and the Severity of the Bleeding.

Introduction: Of the complications following pancreatoduodenectomy (PD), postpancreatoduodenectomy hemorrhage (PPH) is the least common, but severe forms can be life-threatening without urgent treatment. While early PPH is mostly related to surgical hemostasis, late PPH is more likely due to complex physiopathological pathways secondary to different etiologies. The understanding of such etiologies could therefore be of great interest to help guide the treatment of severe, potentially life-threatening, late PPH cases.

A Conservative Management of Spontaneously Ruptured Liver Hydatid Cyst.

Hydatid disease is a zoonotic disease caused mainly by the cestode (tapeworm) , also known as hydatidosis. It is endemic mainly in areas where dog/horse breeding and sheep farming are common, such as Australia, New Zealand and the Mediterranean region. A rare, yet serious, complication of hydatid cyst of the liver is rupture, which could be spontaneous due to increased intra-cystic pressure or following a traumatic injury of the abdomen.

Impact of Vascular Anomalies on Pancreatoduodenectomy Procedure.

Background: One of the critical steps during pancreatoduodenectomy (PD) procedure lies in identifying the complicated vascular anatomy of the resected area. The blood supply usually stems from branches of the celiac and the superior mesenteric arteries. However, only in 55-79% of surgeries, the anatomy of the blood vessels encountered by the surgeon is considered normal, while in the remaining cases, there are vascular variations that make these surgeries even more challenging.

Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis: a meta-analysis of randomized clinical trials.

Background: Early cholecystectomy for acute cholecystitis has proved to reduce hospital length of stay but with no benefit in morbidity when compared to delayed surgery. However, in the literature, early timing refers to cholecystectomy performed up to 96 h of admission or up to 1 week of the onset of symptoms. Considering the natural history of acute cholecystitis, the analysis based on such a range of early timings may have missed a potential advantage that could be hypothesized with an early timing of cholecystectomy limited to the initial phase of the disease.

Unexpected Gastrointestinal Tract injury years following Laparoscopic Adjustable Gastric Banding.

Introduction: Band migration is a late complication of Laparoscopic Adjustable Gastric Banding insertion, although rare it could be life threatening presenting as peritonitis secondary to gastro-intestinal tract injuries. A case of an unexpected extension of severe gastro-intestinal tract injuries secondary to intra-gastric migration and distal band dislocation is reported.

Presentation Of Case: A 53 years old male, with a history of laparoscopic gastric banding 15 years before and known erosion of the band into the gastric lumen was admitted for abdominal pain and raised serum amylase.

Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis revised: Protocol of a systematic review and meta-analysis of results.

Background: Early laparoscopic cholecystectomy has been adopted as the treatment of choice for acute cholecystitis due to a shorter hospital length of stay and no increased morbidity when compared to delayed cholecystectomy. However, randomised studies and meta-analysis report a wide array of timings of early cholecystectomy, most of them set at 72 h following admission. Setting early cholecystectomy at 72 h or even later may influence analysis due to a shift towards a more balanced comparison.