Jejunogastric Intussusception: A Rare Complication of Gastric Surgery

Jejunogastric intussusception is a rare complication of gastric surgery. It usually presents with severe epigastric pain, vomiting, and hematemesis. A history of gastric surgery can help in making an accurate and early diagnosis which calls forth an urgent surgical intervention. Only reduction or resection with revision of the previously performed anastomosis is the choice which is decided according to the operative findings. We present a case of JGI in a patient with a history of Billroth II operation diagnosed by computed tomography. At emergent laparotomy, an efferent loop type JGI was found. Due to necrosis, resection of the intussuscepted bowel with Roux-en-Y anastomosis was performed. Postoperative recovery was uneventful

Intersphincteric Resection and Coloanal Anastomosis in Treatment of Distal Rectal Cancer

In the treatment of distal rectal cancer, abdominoperineal resection is traditionally performed. However, the recognition of shorter safe distal resection line, intersphincteric resection technique has given a chance of sphincter-saving surgery for patients with distal rectal cancer during last two decades and still is being performed as an alternative choice of abdominoperineal resection. The first aim of this study is to assess the morbidity, mortality, oncological, and functional outcomes of intersphincteric resection. The second aim is to compare outcomes of patients who underwent intersphincteric resection with the outcomes of patients who underwent abdominoperineal resection

Controlo químico de infestantes

Uma planta é considerada infestante quando nasce espontaneamente num local e momento indesejados, podendo interferir negativamente com a cultura instalada. As infestantes competem com as culturas para o espaço, a luz, água e nutrientes, podendo atrasar e prejudicar as operações de colheita, depreciar o produto final e assegurarem a reinfestação nas culturas seguintes. Dado o modo de propagação diferenciado das diversas espécies de infestantes, com as anuais a propagarem-se por semente e as perenes ou vivazes a assegurarem a sua propagação através de órgãos vegetativos (rizomas, bolbos, tubérculos, etc.), assim, também o seu controlo quer químico, quer mecânico terá que ser diferenciado, ou seja, para controlar infestantes anuais será suficiente destruir a sua parte aérea, enquanto para controlar infestantes perenes teremos que destruir os seus órgãos reprodutivos. O controlo de infestantes poderá ser químico, através da utilização de herbicidas, ou mecânico pela utilização de alfaias agrícolas, tais como a charrua de aivecas, a charrua de discos, a grade de discos, o escarificador e a fresa. Quando a técnica utilizada na instalação das culturas é a sementeira directa, o controlo das infestantes terá que ser obrigatoriamente químico, enquanto se o recurso à mobilização do solo for a técnica mais utilizada (sistema de mobilização tradicional ou sistema de mobilização reduzida), o controlo das infestantes tanto poderá ser químico como mecânico. Neste trabalho iremos abordar apenas, o controlo químico de infestantes

What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations

OBJECTIVE: Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversion to open cholecystectomy is still inevitable in certain cases. Knowledge of the rate and impact of the underlying reasons for conversion could help surgeons during preoperative assessment and improve the informed consent of patients. We decided to review the rate and causes of conversion from laparoscopic to open cholecystectomy. METHOD: This study included all laparoscopic cholecystectomies due to gallstone disease undertaken from May 1999 to June 2010. The exclusion criteria were malignancy and/or existence of gallbladder polyps detected pathologically. Patient demographics, indications for cholecystectomy, concomitant diseases, and histories of previous abdominal surgery were collected. The rate of conversion to open cholecystectomy, the underlying reasons for conversion, and postoperative complications were also analyzed. RESULTS: Of 5382 patients for whom LC was attempted, 5164 were included this study. The overall rate of conversion to open cholecystectomy was 3.16% (163 patients). There were 84 male and 79 female patients; the mean age was 52.04 years (range: 26-85). The conversion rates in male and female patients were 5.6% and 2.2%, respectively (

Clinically Positive Axillary Lymphadenopathy May Lead to False Diagnosis of Overstaged Breast Cancer in Patients with Sjögren's Syndrome: A Case Report

Sjögren's syndrome (SS) is an autoimmune disease that chronic inflammation and lymph node proliferation. Patients with SS carry a greater risk of developing lymphoproliferative malignancy. In addition to other organ cancers, breast cancer may also occur in these patients. Considering these, breast cancer in patients with SS can be misdiagnosed as being in an advanced stage particularly in the presence of axillary lymphadenopathy. Here, we report a rare case of a 45-year-old woman with SS who presented with a breast mass. Radiology showed a 4 cm solid lesion and conglomerates of axillary lymphadonepathy. A breast biopsy revealed ductal carcinoma in situ. A modified radical mastectomy was performed; however, no axillary metastases were detected. Clinicians should remain vigilant to the possibility that a false clinical impression of axillary metastasis may occur in such patients with breast cancer. Therefore, axillary node status should be verified first

Splenic infarction as a complication of celiac artery thromboembolism: an unusual cause of abdominal pain

Splenic infarction is a relatively uncommon diagnosis and this clinical presentation can mimic other causes of acute abdominal pain. Cardiologic and hematologic disorders are common reasons for this entity. There have been a few series and single case reports of splenic infarction published in peer-reviewed medical journals. We report a 53-year-old patient who had splenic infarction caused by celiac artery thromboembolism. The importance of this case, without any etiological predisposing factors, is that this kind of clinical situation should be considered in the differential diagnosis of abdominal pain

Cultura Arica: un caso para el estudio y educación de la geometría presente en textiles prehispánicos

A partir de un trabajo interdisplinario, presentamos una revisión de los estudios de Etnomatemáticas desarrollados en el área andina, y analizamos los elementos geométricos presentes en piezas textiles prehispánicas pertenecientes al Periodo Intermedio Tardío (ca. 900/1.200- 1.430 d.C.) o “Cultura Arica” (norte de Chile). A partir de esta evidencia, presentamos la experiencia de la Academia de Etnomatemáticas - Arica; estrategia pedagógica que buscó desarrollar actividades teórico-prácticas y que a partir del análisis geométrico permitieron desarrollar la apreciación y valoración del pensamiento matemático presente en los diseños iconográficos de los textiles y tecnología prehispánica

Case Report Jejunogastric Intussusception: A Rare Complication of Gastric Surgery

Jejunogastric intussusception is a rare complication of gastric surgery. It usually presents with severe epigastric pain, vomiting, and hematemesis. A history of gastric surgery can help in making an accurate and early diagnosis which calls forth an urgent surgical intervention. Only reduction or resection with revision of the previously performed anastomosis is the choice which is decided according to the operative findings. We present a case of JGI in a patient with a history of Billroth II operation diagnosed by computed tomography. At emergent laparotomy, an efferent loop type JGI was found. Due to necrosis, resection of the intussuscepted bowel with Roux-en-Y anastomosis was performed. Postoperative recovery was uneventful

Remission of Ulcerated Necrobiosis Lipoidica Diabeticorum after Bariatric Surgery

A 32-year-old woman with type 2 diabetes mellitus suffering from morbid obesity with BMI 45,14 kg/m(2) was operated on. Not only the type 2DM but also one of its complication known as necrobiosis lipoidica diabeticorum remitted postoperatively. Obesity should no longer be regarded simply as a cosmetic problem affecting certain individuals but an epidemic that threatens global well-being. It causes or exacerbates many health problems, and in particular, it is associated with the type 2 diabetes. Necrobiosis lipoidica is a granulomatous skin disease of unknown etiology, associated mainly with diabetes mellitus. We presented in this paper a morbid obese case of necrobiosis lipoidica diabeticorum with dramatic good response to bariatric surgery

Laparoscopic versus Open Appendectomy: Where Are We Now?

Rezumat Apendicectomia prin abord laparoscopic versus abord deschis: pentru ce optãm? Scop: Deaei avantajele procedurilor laparoscopice au fost intens studiate pe parcursul ultimelor douã decenii, apendicectomia laparoscopicã nu a putut fi desemnatã ca procedurã standard de tratament din cauza unor dezavantaje de tipul timpilor operatori aei al costurilor crescute. Obiectivul studiului nostru este de a reevalua rezultatele pe termen lung ale abordului laparoscopic versus cel chirurgical deschis pentru aceastã patologie pe baza datelor actuale. Metode: Datele pacienåilor supuaei apendicectomiei între ianuarie 2012 aei iulie 2012 au fost analizate prospectiv. Datele demografice ale pacienåilor, durata procedurii, perioada de internare, nevoia de analgezice, scorul VAS aei rata mortalitãåii au fost înregistrate. Rezultate: Din 241 de pacienåi, 120 (49.8%) au suferit intervenåie deschisã aei 121 (50.2%) au fost operaåi laparoscopic. Perioada intervenåiei a fost similarã între cele douã grupuri (p=0.855). Scorurile VAS dupã prima orã (p=0.001), dupã 6 (p=0.001) aei dupã 12 ore de la operaåie (p=0.028) au fost mai mari în grupul de apendicectomii prin abord deschis (p=0.001). Nu au existat diferenåe statistice vizând ratele de morbiditate între grupul prin abord deschis aei cel prin abord laparoscopic (p=0.617). Concluzii: Cele douã tehnici operatorii sunt similare în ceea ce priveaete perioada de internare, durata operaåiei aei complicaåiile postoperatorii. Apendicectomia laparoscopicã reduce nevoia de analgezice aei scorurile VAS; aceasta ar trebui prin urmare luatã în considerare ca standard de aur în tratamentul chirurgical al apendicitei acute. Cuvinte cheie: apendicitã, apendicectomie, procedurã laparoscopicã, abces abdominal, infecåia plãgii chirurgicale Abstract Purpose: Although the advantages of laparoscopic procedures has been well studied over the last two decade, laparoscopic appendectomy could not to be a standard therapy due to some disadvantages such as longer operative time and higher cost. The objective of our study is to re-evaluate the outcomes of laparoscopic versus open appendectomy with current data. Methods: Between January 2012 and July 2012, the data of the patients who had appendectomy were recorded prospectively. Patients' demographics, duration of procedure, length of hospital stay, need of analgesics, postoperative visual analogue scale scores and morbidity were assessed