Richter's type strangulated femoral hernia containing caecum and appendix masquerading as a groin abscess.

Femoral hernias are challenging conditions, not only because their diagnosis is often missed, but also because if left undiagnosed and untreated, their complications are severe and often life-threatening. The authors present the second reported case of a femoral hernia of the Richter's variety containing caecum and appendix that, following strangulation and perforation, manifested as a groin abscess.

Malignant paraganglioma of the abdomen.

We present a case of non-functioning malignant paraganglioma of the abdomen with cervical lymph node metastases. At laparotomy the tumor was considered unresectable. The patient received palliative radiation therapy and died 3 months later from disseminated disease.

Gastrointestinal tract metastasis as first presentation of breast cancer.

Gastrointestinal metastases of breast cancer are a rare occurrence. It is even rarer to be the first manifestation of an unknown breast cancer. We present 2 cases of metastatic breast cancer of the lobular type to the stomach and large bowel in 2 women, initially considered as primary disease.

Abdominal metastases from lung cancer resulting in small bowel perforation: report of three cases.

Metastatic lung cancer to the small bowel is a rare occurrence. Acute complications such as perforation, hemorrhage and obstruction are even rarer. We present 3 cases of small bowel perforation from metastatic lung cancer.

Randomized comparison between different insufflation pressures for laparoscopic cholecystectomy.

Laparoscopy using carbon dioxide insufflation induces adverse effects in both the cardiovascular and the respiratory function. The use of low pressure pneumoperitoneum has been shown to reduce adverse hemodynamic effects. However, its effect on tissue trauma and postoperative pain and recovery remains controversial.

A new tension-free technique for the repair of umbilical hernia, using the Prolene Hernia System--early results from 48 cases.

Tension-free repair using the Prolene Hernia System (PHS) has been widely adopted for inguinal hernias with excellent results. In our department, a new technique for umbilical hernia repair, using the PHS, has been developed. Between 2000 and 2002, 48 patients underwent tension-free umbilical hernia repair, using the PHS.

Transarterial locoregional immunostimulation and chemotherapy in patients with unresectable secondary liver tumours.

Ten patients with unresectable liver secondaries from colorectal carcinoma were included in this study. All patients were treated with combined locoregional transarterial targeting immunostimulation and chemotherapy. After abdominal surgery for the introduction of an arterial catheter into the hepatic artery via the gastroduodenal artery, all patients survived the operation and their response to the treatment was satisfactory.

Intrahepatic cholangiojejunostomy in biliary stricture following resectional liver surgery.

Background: Biliary strictures after resectional liver surgery is a severe complication and remains a challenge. In this study we present our experience with intrahepatic cholangiojejunostomy (IHCJ) as the method of choice for the management of this complication.

Methods: Between September 1983 and January 1993, 115 IHCJs were performed.

Induced in vivo targeted transarterial and transvenous immunostimulation in patients with unresectable pancreatic carcinoma.

On the basis of the preliminary results of this study, in vivo dual immunostimulation in patients with advanced pancreatic cancer appears to be a promising therapeutic alternative. A surgical technique is presented in which the spleen of the patient is used as the target organ for in vivo lymphokine activated killer cell generation. Additionally, applying locoregional transvenous administration of gamma-INF and IL2 in the area of the tumor, tumor infiltrating lymphocytes (TIL) area activated, thus completing the system of dual in vivo immunostimulation.

Technical considerations and results of a "new" method of reconstruction of alimentary continuity after duodenopancreatectomy.

A total of (152) patients who consecutively underwent extended pancreaticoduodenectomy between 1983 and August 1992 had reconstruction of alimentary continuity, using two independent jejunal loops. One for the fashioning of a pancreatic and biliary anastomosis and the other for creating the gastric anastomosis. From the results of this study it has been shown that the present technique is contributing to low mortality, early morbidity and a satisfactory quality of post-operative life in long-term survivors.

A new look in the management of unresectable primary hepatocellular carcinoma.

From January 1992 to October 1992, nine patients with unresectable primary hepatocellular carcinoma were treated either by liver resection combined with transarterial on-target chemotherapy (n = 4) or by transarterial on-target chemotherapy alone (n = 5). All nine patients were seen with diffuse spread of their disease and were considered as refractory to surgical treatment. The patients who had liver resection combined with alcohol transtumoral injection of the residual tumor in the liver remnant and transarterial lipiodol on-target chemotherapy, responded well and were seen postoperatively with a significant decrease in size of their residual tumor, which was found histologically to have advanced necrotic changes.