The challenging management of hepatopulmonary fistulas.

Hepatopulmonary fistula although benign in nature carries an unacceptable mortality risk up to 10.3% in some case series mainly due to surgical complications. From the first description by Ferguson and Burford in 1967 till present different approaches have been applied and with the introduction of less invasive techniques the results have significantly improved.

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.

Colonic obstruction secondary to incarcerated Spigelian hernia in a severely obese patient.

Spigelian hernia is a rare hernia of the ventral abdominal wall accounting for 1-2% of all hernias. Incarceration of a Spigelian hernia has been reported in 17-24% of the cases. We herein describe an extremely rare case of a colonic obstruction secondary to an incarcerated Spigelian hernia in a severely obese patient.

Ovarian endometriosis associated with ovarian cancer and endometrial-endocervical polyps.

Aim: To determine the prevalence of ovarian cancer and endometrial polyps in women with moderate and severe ovarian endometriosis.

Methods: A retrospective analysis of 667 cases of moderate and severe endometriosis laparoscopically and histologically confirmed during the period 1997-2004.

Results: One hundred and ninety-three (29%) of cases were American Fertility Society (AFS) stage III (moderate endometriosis) and 473 (71%) were AFS stage IV (severe endometriosis).