Retained Surgical Foreign Bodies after Surgery

The problem of retained surgical bodies (RSB) after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis

Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

<p>Abstract</p> <p>Introduction</p> <p>The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception.</p> <p>Case presentation</p> <p>A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum.</p> <p>Conclusions</p> <p>Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications.</p

The Diagnostic Role of Hyperbilirubinemia in Complicated and Non -complicated Appendicitis.

Background: Acute appendicitis is one of the most frequent causes of abdominal pain. Early diagnosis is the key to success for the surgeon, followed by the treatment with operation or conservative treatment as a new approach, before the stage of gangrenous appendicitis or perforation occurs. Aim: This study aims to establish he role of hyperbilirubinemia as a laboratory marker in prediction of acute appendicitis in the early diagnosis. Materials and methods: This is a cross-sectional study; it included 201 patients admitted in the emergency ward with suspicion for acute appendicitis. All patients that participated in this study have been subject to appendectomy. The blood samples were taken from all patients in order to analyze the level of total/direct bilirubin. Results: The study samples of 201 patients consisted of 67.7% with complicated appendicitis and 32.3% with non-complicated appendicitis. The sensitivity, specificity, PPV, NPV for laboratory marker, as predictor for complicated vs non-complicated cases of appendicitis was as follows: Total bilirubin; specificity (72.3%), sensitivity (54.4%), PPV (80.4%), NPV (43.1%), Conclusion: Elevation of total/direct bilirubin level in patients with clinical signs of acute appendicitis might predict the stage of acute appendicitis, such prediction may help surgeons to provide accurate treatment of the disease without delay in the diagnosis. This accuracy can be further supplemented by using Alvarado scoring model during the clinical approach

Mesenteric Meckel’s diverticulum or intestinal duplication cyst: A case report with review of literature

Introduction: A Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal (GI) tract. They arise from the middle-to-distal ileum. Contrary to MD, intestinal duplication cyst (IDC) is uncommon congenital anomaly of GI, but can occur anywhere from the tongue to the anus. Presentation of case: Here we report an 18-year-old male who presented to the department of abdominal surgery with chronic abdominal pain, frequent vomiting and mild abdominal distension. Following radiological investigation, a laparotomy was performed with the preoperative diagnosis of a mesenteric cyst. Intraoperativelly it became apparent that the cystic mass was on the mesenteric aspect of the small bowel without intestinal communication. Resection of the cyst was performed. Histological examination of the specimen revealed the presence of gastric tissue, which resembles MD. Although, the exact diagnosis of this cystic mass is ambiguous between MD and IDC, because of similar clinical signs, their complications and presence of gastric mucosa, however surgical treatment is gold standard of both. Conclusion: This case report underlines the necessity of how to differentiate between MD and IDC, although, surgical management is recommended for both