Acute abdomen from chylous peritonitis: a surgical diagnosis. Case report and literature review.

Acute accumulation of chyle in the peritoneal cavity is a rare event (less than 100 cases are described in the literature) and is to be distinguished from chylous ascites, which is characteristically chronic. It is frequently idiopathic, and diagnosis is usually made at laparotomy, whenever signs of acute peritonitis impose it. Peritoneal toilette and drainage are the only treatment required, and the prognosis is excellent.

Hemoperitoneum after percutaneous liver biopsy. Video-laparoscopic management.

Background: Percutaneous liver biopsy is a safe procedure, with a low rate of major complications. Among these massive hemoperitoneum is the most life threatening, and its management sometimes leads to an emergency invasive surgical approach.

Case Report And Results: The following case highlights the possible role of laparoscopy in diagnosis and treatment of this condition.

Laparoscopy in afferent loop obstruction presenting as acute pancreatitis.

Background: We describe an afferent loop obstruction caused by an adhesion band in a case of distal gastrectomy with Roux-en-Y end-to-side jejunal anastomosis for cancer.

Methods: An initial clinical presentation of acute pancreatitis was ruled out by a computed tomography scan, which revealed intestinal obstruction; it was then confirmed on laparoscopy. Definitive treatment was laparoscopic adhesiolysis.

Introduction of laparoscopic appendectomy: a retrospective comparison with the open technique.

Laparoscopic appendectomy (LA) is gaining favour as an alternative to the traditional laparotomic technique (OA) despite the persistence of controversy regarding indications, morbidity, hospital stay, costs and surgical time. We present a retrospective analysis of our first three years of experience with the procedure. During this period we performed 235 appendectomies (102 laparoscopic and 133 laparotomic).

[Surgical treatment of refractory ascites with peritoneovenous shunt].

Leveen and associates described a peritoneo-venous shunt which proved to be useful in patients with intractable ascites. Medical therapy, paracentesis and peritoneovenous shunt have been compared, but there is uncertainty about their relative merits. Therefore, the leveen device has be placed in last years in an increasing number of patients: it has not been shown by prospective trials to prolong survival significantly, although it may shorten hospitalization and improve the quality of life.