Left-sided Spigelian hernia with nontypical hernial sac content

Spigelian hernia is one of the most uncommon hernia of the abdominal wall. Authors present 53 years old women with left sided spigelian hernia containing: caecum with appendix and ileum, which was an uncommon content of hernial sac. Past medical history of urinary bladder operation suggested postoperative hernia. However, the correct diagnosis was made during the operation. Hernioplasty was made with mesh onlay method. The postoperative course was unevenful

Lewostronna przepuklina Spigela z nietypową zawartością worka

Przepuklina Spigela należy do najrzadziej występujących przepuklin przedniej ściany jamy brzusznej. Autorzy przedstawiają przypadek 53-letniej chorej z lewostronną przepukliną Spigela o nietypowej zawartości, którą stanowiła kątnica z wyrostkiem robaczkowym i kilkoma pętlami jelita cienkiego. Epizod przebytej przed kilku laty operacji pęcherza moczowego wskazywał na przepuklinę pooperacyjną. Jednak prawidłowe rozpoznanie zostało postawione dopiero śródoperacyjnie. Plastykę przepukliny wykonano z użyciem siatki. Przebieg pooperacyjny był niepowikłany

Current Approaches for the Curative-Intent Surgical Treatment of Pancreatic Ductal Adenocarcinoma

Radical resection is the only curative treatment for pancreatic cancer. However, only up to 20% of patients are considered eligible for surgical resection at the time of diagnosis. Although upfront surgery followed by adjuvant chemotherapy has become the gold standard of treatment for resectable pancreatic cancer there are numerous ongoing trials aiming to compare the clinical outcomes of various surgical strategies (e.g., upfront surgery or neoadjuvant treatment with subsequent resection). Neoadjuvant treatment followed by surgery is considered the best approach in borderline resectable pancreatic tumors. Individuals with locally advanced disease are now candidates for palliative chemo- or chemoradiotherapy; however, some patients may become eligible for resection during the course of such treatment. When metastases are found, the cancer is qualified as unresectable. It is possible to perform radical pancreatic resection with metastasectomy in selected cases of oligometastatic disease. The role of multi-visceral resection, which involves reconstruction of major mesenteric veins, is well known. Nonetheless, there are some controversies in terms of arterial resection and reconstruction. Researchers are also trying to introduce personalized treatments. The careful, preliminary selection of patients eligible for surgery and other therapies should be based on tumor biology, among other factors. Such selection may play a key role in improving survival rates in patients with pancreatic cancer