19 research outputs found
Massive Gastrointestinal Bleeding and Obstruction of the Ureter Caused by the Migration of a Swallowed Toothpick from the Sigmoid Colon ā A Case Report
In this study, a case of an ingested toothpick partially migrating from the sigmoid colon, causing massive lower gastrointestinal
bleeding due to arterial-colic fistula, and stricture of the left ureter is presented. A 70-year-old male was admitted
to the emergency department after having feces mixed with fresh and coagulated blood for the past two days. Computed
tomography and retrograde ureteropyelography showed the stricture of the left ureter, 1.5 cm below the branching
of iliac artery, without any signs of malignancy. Colonoscopy showed fresh blood in the rectum and sigmoid colon up to
the neoplasm like granulation tissue mixed with fresh and coagulated blood, which almost obstructed the lumen. Explorative
laparotomy showed a foreign body (toothpick) perforating the sigmoid colon through the mesenterial wall, and being
stocked with one-third into the left internal iliac artery, causing arterial-colic fistula. The remaining part of the
toothpick was surrounded by granulation tissue and chronic inflammatory process, pressing on the distal third of the left
ureter. We conclude that a swallowed toothpick may cause a significant gastrointestinal injury with a wide variety of
clinical manifestations, and it must be treated with caution. The imaging studies are often inadequate in detecting toothpicks,
and thus, we insist on a physical examination, as the best indicator of injury
Efficacy of IP6 + inositol in the treatment of breast cancer patients receiving chemotherapy: prospective, randomized, pilot clinical study
<p>Abstract</p> <p>Background</p> <p>Prospective, randomized, pilot clinical study was conducted to evaluate the beneficial effects of inositol hexaphosphate (IP<sub>6</sub>) + Inositol in breast cancer patients treated with adjuvant therapy.</p> <p>Patients and methods</p> <p>Patients with invasive ductal breast cancer where polychemotherapy was indicated were monitored in the period from 2005-2007. Fourteen patients in the same stage of ductal invasive breast cancer were involved in the study, divided in two randomized groups. One group was subjected to take IP<sub>6 </sub>+ Inositol while the other group was taking placebo. In both groups of patients the same laboratory parameters were monitored. When the treatment was finished, all patients have filled questionnaires QLQ C30 and QLQ-BR23 to determine the quality of life.</p> <p>Results</p> <p>Patients receiving chemotherapy, along with IP<sub>6 </sub>+ Inositol did not have cytopenia, drop in leukocyte and platelet counts. Red blood cell counts and tumor markers were unaltered in both groups. However, patients who took IP<sub>6 </sub>+ Inositol had significantly better quality of life (p = 0.05) and functional status (p = 0.0003) and were able to perform their daily activities.</p> <p>Conclusion</p> <p>IP<sub>6 </sub>+ Inositol as an adjunctive therapy is valuable help in ameliorating the side effects and preserving quality of life among the patients treated with chemotherapy.</p
Formation of Adhesions at Surgical Meshes in a Rat Experimental Model
Abdominal wall hernias are surgical problem that are easily solved with laparoscopic surgery. The determining factor
for the success of the operation is the right choice and use of surgical mesh as the support material. The most common
complication of surgical mesh placement is the formation of adhesions. Aim of this paper is to determine whether there is
a statistic difference in formation of adhesions between different surgical meshes in lab environment. Wistar rats were
used as the experimental model. After the anaesthesia a 1x1 cm defect of the abdominal wall was made, but the skin was
left intact. The mesh was placed directly on the internal organs. The experiment considered four different mesh types. After
set time periods of one, two or four weeks the animals were sacrificed and the amount of formed adhesions were evaluated
based on the modified Diamond scale. Immediately after the first week we found a statistically significant difference
in the adhesion occurrence rate between compared materials. The smallest amount of adhesions was caused by polypropylen
+ polydoksanon mesh, and the most by polypropilen mesh. Polypropylen + polyglactin mesh showed significant
reduction of adhesion formation between the tested weeks. We can conclude that polypropylen + polydoxanon meshes
are superior for ventral hernia operation, because those defects are in close contact with the internal organs and it is
very important to have the smallest amount of adhesions
Giant Perianal Angiomyofibroblastoma ā A Case Report
A 45-year old female had a long history of slow growing perianal tumor at the right side of her anus. Encapsulated
tumour was found intraoperatively and completely excised using the Harmonic Scalpel. Tumour was well-circumscribed
and relatively firm; measuring 12x6x4 cm. Histologically it was composed of oval to spindle cells with minimal nuclear
atypia, set in mucous matrix with numerous thin-walled blood vessels. Immunohistochemically, expression of smooth-
-muscle actin and desmin, as well as estrogen and progesterone receptor were found in the tumour cells. The diagnosis of
angiomyofibroblastoma was established. This rare benign tumour typically involves vulvovaginal, pelvic and perinal region.
It is important to separate this neoplasm from locally invasive aggressive angiomyxoma and low grade fibromyxoid
sarcoma, which can arise in the the same localisation. The patient was discharged on the third postoperative day
and no recurrence was noted in 18 months follow-up
Formation of Adhesions at Surgical Meshes in a Rat Experimental Model
Abdominal wall hernias are surgical problem that are easily solved with laparoscopic surgery. The determining factor
for the success of the operation is the right choice and use of surgical mesh as the support material. The most common
complication of surgical mesh placement is the formation of adhesions. Aim of this paper is to determine whether there is
a statistic difference in formation of adhesions between different surgical meshes in lab environment. Wistar rats were
used as the experimental model. After the anaesthesia a 1x1 cm defect of the abdominal wall was made, but the skin was
left intact. The mesh was placed directly on the internal organs. The experiment considered four different mesh types. After
set time periods of one, two or four weeks the animals were sacrificed and the amount of formed adhesions were evaluated
based on the modified Diamond scale. Immediately after the first week we found a statistically significant difference
in the adhesion occurrence rate between compared materials. The smallest amount of adhesions was caused by polypropylen
+ polydoksanon mesh, and the most by polypropilen mesh. Polypropylen + polyglactin mesh showed significant
reduction of adhesion formation between the tested weeks. We can conclude that polypropylen + polydoxanon meshes
are superior for ventral hernia operation, because those defects are in close contact with the internal organs and it is
very important to have the smallest amount of adhesions
Acute Appendicitis and Ileal Perforation with a Toothpick Treated by Laparoscopy
A 69-year-old man underwent an emergency laparoscopic procedure after the acute appendicitis diagnosis has been
established. Laparoscopic exploration showed inflamed appendix and perforation of terminal ileum with a swallowed
part of the wooden toothpick. The treatment consisted of typical laparoscopic appendectomy and laparoscopic removal of
the foreign body, followed by laparoscopic closure of the perforation site and lavage of the abdominal cavity. The postoperative
course was uneventful and the patient was discharged from the hospital on day 3 after the operation
Laparoscopic Abdominal Cysts Fenestration Using Harmonic Scalpel
The use of ultrasonically activated scalpel for tissue cutting and coagulation is a potential replacement for electrosurgery,
which can be related to different complications. Its working principle is to transform the electric power into
the mechanical longitudinal movement of the working part of the instrument, by a piezoelectric transducer situated in
the hand piece. Between October 2000 and June 2004, six patients with abdominal cysts were treated by laparoscopy, using
the harmonic scalpel. The average age was 40.8 (ranging from 15ā60) years. Laparoscopic abdominal cyst fenestration
was performed in five patients, and laparoscopic cholecystectomy and abdominal cyst fenestration were done in one
patient during the same operation. The average duration of the operation was 40 (ranging from 25ā70) minutes and hospital
stay was 2.8 (ranging from 1ā5) days. Laparoscopic abdominal cyst fenestration using the harmonic scalpel is a
safe and successful operation, with good results including all the advantages of the minimally invasive surgery
Torsion of Epiploic Appendage Mimic Acute Appendicitis
Epiploic appendagitis is a rare cause of focal abdominal pain which, depending on its localisation, can mimic a variety
of abdominal diseases. We report a case of 36-year-old woman who presented with a classic signs of acute appendicitis.
On examination, the obese, afebrile, and had very strong right iliac fossa tenderness and guarding. The white cell
count was 12.82Ā“109/L, and C reactive protein count was 15.13MG/DL. She underwent emergency laparoscopic procedure
after the acute appendicitis diagnosis has been established. Laparoscopic exploration of the abdominal cavity showed
vermiform, no inflamed, appendix and necrotic appendix epiploica of the caecum. The treatment consisted of typical
laparoscopic appendectomy and laparoscopic resection of the necrotic appendix epiploica. The patient made rapid recovery
and was discharged from the hospital on second day after the operation. Histological investigation of the appendix
epiploica revealed gangrenous epiploic appendage
Partial Cecal Necrosis Treated by Laparoscopic Partial Cecal Resection
Acute colonic ischemia is the common cause of colitis in elderly population. However, isolated ischemic necrosis of cecum
is rare entity, often associated with variety of conditions. Here we present a case of a 73-year old woman with a past history
of hypertension presented with clinical symptoms of right lower quadrant abdominal pain and tenderness localized
to the right lower quadrant, guarding and rebound tenderness. With diagnosis of acute appendicitis, the patient underwent
laparoscopy where the cecal partial necrosis was discovered. Necrotic area of cecum was excised using two endoscopic
cutters and laparoscopic appendectomy was performed. Pathologist report showed thrombosis of vessels and necrosis
of entire cecal wall. The patient completely recovered without any surgical complications. This is the first case of
partial cecum necrosis laparoscopicaly managed and with a partial cecal resection only
Torsion of Epiploic Appendage Mimic Acute Appendicitis
Epiploic appendagitis is a rare cause of focal abdominal pain which, depending on its localisation, can mimic a variety
of abdominal diseases. We report a case of 36-year-old woman who presented with a classic signs of acute appendicitis.
On examination, the obese, afebrile, and had very strong right iliac fossa tenderness and guarding. The white cell
count was 12.82Ā“109/L, and C reactive protein count was 15.13MG/DL. She underwent emergency laparoscopic procedure
after the acute appendicitis diagnosis has been established. Laparoscopic exploration of the abdominal cavity showed
vermiform, no inflamed, appendix and necrotic appendix epiploica of the caecum. The treatment consisted of typical
laparoscopic appendectomy and laparoscopic resection of the necrotic appendix epiploica. The patient made rapid recovery
and was discharged from the hospital on second day after the operation. Histological investigation of the appendix
epiploica revealed gangrenous epiploic appendage