Detection of tract formation for prevention of bile peritonitis after T-tube removal. Case report.

Bile leakage after removal of T-tube is a relatively rare complication caused by inadequate tract formation around the tube. We report a case of bile peritonitis after removal of a latex T-tube. The patient underwent reoperation and a new T-tube was introduced.

Recurrence and long-term outcome after open cystectomy with omentoplasty for hepatic hydatid disease in an endemic area.

Background/purpose: Surgery is the cornerstone in the treatment of echinococcosis. The purpose of this study is to report the long-term results of partial cystectomy and omentoplasty in the management of hepatic hydatid disease.

Material And Methods: In a retrospective survey over the past 20 years (1982-2001) there were 36 patients (13 men and 23 women, with a mean age of 50 years) with hepatic echinococcosis, treated by partial cystectomy and omentoplasty.

The effect of preincisional periportal infiltration with ropivacaine in pain relief after laparoscopic procedures: a prospective, randomized controlled trial.

Background And Objectives: It is essential to minimize pain after laparoscopic surgery. This study examined the effect of wound infiltration by a long-acting local anesthetic.

Methods: This prospective, randomized study includes 190 laparoscopic procedures carried out by the same surgeon.

Management of gallstone ileus.

Background/purpose: Gallstone ileus is an uncommon complication of cholelithiasis in the elderly with a high morbidity and mortality rate. This study aims to clarify the current surgical management.

Methods: In a retrospective survey over the past 11 years there were 9 patients with gallstone ileus, all elderly (mean age, 77 years), among 2242 cholecystectomies (0.

Splenectomy versus spleen-preserving surgery for splenic echinococcosis.

Background/aims: The spleen is the third most common location of hydatid disease after liver and lung. The aim of this study was to analyse the long-term outcome of surgical treatment of patients with splenic echinococcosis comparing splenectomy with spleen-preserving surgery.

Methods: During a period of 25 years (1976-2001), 19 (5.

Hypoplasia of the right hepatic lobe combined with a floating gallbladder.

Agenesis or hypoplasia of the right hepatic lobe combined with a floating gallbladder is an extremely rare condition. We report a case of hypoplasia of the right hepatic lobe, discovered in a 65-year old female. This was an incidental finding at CT scan for staging of a right colonic cancer.

Malignant fibrous histiocytoma of the abdominal cavity: report of a case.

Malignant fibrous histiocytoma (MFH) is a soft-tissue sarcoma originating from fibroblast cells, characterized by a high rate of metastasis or recurrence. This tumor rarely develops in the gastrointestinal tract, with no more than 30 cases described in the literature. We report a case of MFH of the abdominal cavity in a 45-year-old woman who presented with epigastric pain, anorexia, and weight loss.

Systemic endotoxaemia following obstructive jaundice: the role of lactulose.

Background: Obstructive jaundice is often accompanied by bacterial translocation and subsequent sepsis. The effect of lactulose in preventing that process was evaluated in an experimental model. Obstructive jaundice was induced in 23 rabbits after common bile duct ligation.

Plummer-Vinson syndrome.

Plummer-Vinson syndrome is characterized by dysphagia, iron deficiency, anemia and the presence of esophageal web or webs. Two cases of this syndrome are reported in middle-aged women, which were treated over the last eight years. Both patients presented with dysphagia, anemia, sideropenia, glossitis and cheilitis.

Disruption of the small-intestine mucosal barrier after intestinal occlusion: a study with light and electron microscopy.

It is known that the gut may serve as a reservoir for various microorganisms, which under specific circumstances may intrude into the systemic circulation, causing systemic infections. The aim of the present study was to estimate the "critical time" of disruption of the small-intestine mucosal barrier in conditions of experimentally induced intestinal occlusion, based on the histopathological alterations observed under light and electron microscopy. Forty rabbits underwent small-intestine obstruction through ligation with a nonabsorbable suture.

Intrahepatic lithiasis as a late complication of hepaticojejunostomy.

The development of intrahepatic lithiasis proximal to a bilodigestive anastomosis is rare. We report a case of intrahepatic lithiasis of the right hepatic duct, which developed almost 6 years after a hepaticojejunostomy performed for an iatrogenic lesion of the common hepatic duct. The patient experienced repeated episodes of acute cholangitis and was treated with intracorporeal lithotripsy and dilation of the stenosis.

Primary malignant melanoma of the small intestine: report of a case.

The small intestine is the most common site of gastrointestinal (GI) metastases from cutaneous malignant melanoma; however, primary malignant melanoma originating in the small intestine is extremely rare. We report the case of a 72-year-old man found to have a primary malignant melanoma in the ileum. The patient presented with anorexia, weight loss, diffuse colicky abdominal pain, and episodic rectal bleeding.

Tropisetron vs ondansetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy: a randomized double-blind, placebo-controlled study.

Background: Postoperative nausea and vomiting are observed in increased frequency after laparoscopic surgery. This study was performed in order to compare the efficacy of two 5-hydroxytryptamine-3 (5-HT3) receptor antagonists, ondansetron and tropisetron, in preventing postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy.

Methods: Using a randomized, double-blind study design, 87 ASA I and II patients scheduled for laparoscopic cholecystectomy were randomly assigned to receive 4 mg ondansetron (Group A, n = 29), 5 mg tropisetron (Group B, n = 31), or placebo (Group C, n = 27) intravenously (IV) before induction of anesthesia.

An unusual case of retroperitoneal accessory spleen with vascular supply directly from the aorta.

We report on a case of a retroperitoneal accessory spleen with vascular supply directly from the aorta. A 47-year old woman presented with a six-month history of epigastric pain, intermittent nausea and vomiting. The CT scan of the abdomen revealed the presence of a retroperitoneal tumor between the spleen, left kidney and pancreas.

Congenital web of the common bile duct in association with cholelithiasis.

Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. The age at presentation and the clinical symptomatology of these anomalies depend on the grade of the biliary obstruction. We report a case of a common bile duct septum in association with cholelithiasis in a 30-year-old woman.

Helicobacter pylori infection in patients undergoing appendectomy.

Aims: Helicobacter pylori has been found in the upper gastrointestinal tract; it is incriminated as aetiological factor in various pathological conditions. This prospective study assesses the presence of this microorganism in the appendix flora and the possible role of its infection in the pathogenesis of acute appendicitis.

Methods: H.

Incidence of abdominal wall hernias in patients undergoing aortic surgery for aneurysm or occlusive disease.

Background: The aim of this study was to compare the incidence of abdominal and incisional hernias in patients with abdominal aortic aneurysm (AAA) versus patients with aortoiliac occlusive disease (AOD).

Patients And Methods: The study included retrospectively 121 patients, who underwent elective aortic surgery due to AAA (n = 63) or AOD (n = 58) in the period between January 1998 and January 2000. The patients were examined for the presence of abdominal hernias upon admission, as well as for the development of incisional hernias on follow-up.

Congenital double pyloric ostium in the adult.

Duplication of the pylorus, an extremely rare congenital anomaly of the stomach, consists of two openings connecting the antrum of the stomach to the duodenal bulb. Approximately 70 cases of double pylorus have been described in the literature, most of which are associated with the presence of chronic peptic ulcers, thus indicating an acquired origin of the condition. We report a case of congenital double pylorus in a 64-year-old man who complained about mild postprandial epigastric discomfort and nausea of approximately 3 months' duration.

Modern stapled Longo procedure vs. conventional Milligan-Morgan hemorrhoidectomy: a randomized controlled trial.

Background And Aims: Postoperative pain is the most distressing sequela of conventional hemorrhoidectomy. A modern alternative of circumferential mucosectomy has been proposed to reduce the pain in this procedure.

Patients And Methods: This controlled trial included 80 patients with second to fourth degree hemorrhoidal disease operated on over a 2-year period.