Baffling perforation of the colon

Idiopathic perforation of the colon is extremely unusual and unexpected, with a very limited number of published reports. The condition’s definition depends on the absence of any detectable pathology in the bowel wall that could be responsible for the perforation. A 62-year-old male patient presented with acute thrombosis of the brachial artery. This was successfully treated with an open thrombectomy and systemic anticoagulation, with rapid resolution of the symptoms. During the hospital stay the patient had regular bowel movements and no abdominal complaints. Suddenly he complained of acute abdominal pain. Physical examination and emergency CT scan of the abdomen were consistent with generalized peritonitis. Emergency laparotomy revealed two perforations of the mid-sigmoid colon, each measuring 1.5 x 1.5 cm, an

Impact of Graft Type on Outcome in Pediatric Liver Transplantation A Report From Studies of Pediatric Liver Transplantation (SPLIT)

Technical variant liver transplantation comprising reduced, split, and live-donor grafts evolved to address the need for size appropriate organs for pediatric liver recipients. This study will examine the outcome and morbidity of the technical variant techniques relative to whole organ transplants in the Studies of Pediatric Liver Transplantation (SPLIT) database

Biomechanical Porcine Model of Median Sternotomy Closure

Background. Healing complications following median sternotomy commonly include instability, nonunion, and infection. They are associated with a high mortality rate if mediastinitis supervenes. Closure complications are best avoided by improving stability at the union, but there has thus far been no widespread agreement among surgeons about relative superiority among the available closure techniques. Materials and methods. A biological sternotomy closure model was developed utilizing whole porcine sterna. A special stainless-steel clamp with multiple spikes was created to reliably attach the sterna to a biomechanical testing device. Results. Two wiring techniques, single peristernal and pericostal figure-eight, were used in 14 fresh cadaveric porcine sterna. The more rigid closure utilized single peristernal wires (P \u3c 0.0001). There was no tissue associated with clamp spikes penetrating the specimen\u27s layers, and there was no clamp displacement even at closure failure loads. Conclusions. The porcine sternotomy model is a valuable tool for comparing closure techniques based on geometrical and mechanical wiring patterns. The model\u27s low cost and easy reproducibility make it a promising first step in sternotomy closure research. The stainless-steel clamp used in the porcine model provided reliable repeat specimen fixation