Port-site metastasis of pancreatic adenocarcinoma following 'successful' completion of neoadjuvant chemoradiation using FOLFIRINOX

Diagnostic laparoscopy is a well-established investigation as part of the initial staging for malignancy of the pancreatic head and tail. To date, there have only been a handful of cases of port-site metastasis due to pancreatic cancer, and none of those were following diagnostic laparoscopy and/or neoadjuvant treatment

Laparoscopic diagnosis and management of peritonitis chronica fibrosa incapsulata

Sclerosing encapsulating peritonitis (SEP) is a total or partial fibrocollagenous membrane encapsulating the small intestine which can result in an acute or subacute small bowel obstruction. Overall, SEP is an incompletely understood peritoneal adhesional phenomena that has been described by other names including peritonitis chronica fibrosa incapsulata and ‘abdominal cocoon’. 1 We report the first Australian case managed with a completely laparoscopic surgical approach

Fast-track ambulatory abscess pathway : an Australian streamlined emergency surgery pathway

Background: Superficial skin abscesses account for a significant burden of emergency surgical admissions. The aim of this study was to evaluate the effectiveness of an ambulatory care pathway for emergently treating abscesses of the body requiring operative drainage. Method: A retrospective study of a prospective patient database was performed, using randomized patient selection. Patient demographics, length and cost of stay were compared between patients undergoing operative management for skin abscess before and after the implementation of the fast-track ambulatory abscess pathway (FAAP). Results: In total, 100 patients were analysed with 50 in the pre-ambulatory care pathway group and 50 in the FAAP group. The pre-ambulatory care pathway group had a mean age of 37.7 ± 15.8 years versus FAAP group of 35.3 ± 14.5 years. Total length of stay for the group was 85 versus 17 days with a mean comparison of 1.7 days versus 0.34 days (P < 0.001). This translated into a total cost saving of $74 100 in the FAAP group, with a mean comparison cost between the groups of$2884 versus $1402 (P < 0.001). Both reductions in length of stay and cost of stay were statistically significant after implementation of the pathway. Conclusion: This is the first Australian study to report the findings from an ambulatory care pathway for an emergency surgical intervention. We have shown that skin abscesses presenting through emergency can be managed as a day-case procedure, thereby decreasing these patients' overall length and cost of stay

Surgical tetralogy : simultaneous perforated gastric ulcer and appendicular perforation with liver and cerebral abscesses

A 73-year-old alcoholic male was referred to our surgical service with rigors and a 3-week history of abdominal pain. He reported regular use of non-steroidal anti-inflammatory medications (NSAIDs) for treatment of his presenting symptoms