Multi-Stream Saline-Jet Dissection Using a Simple Irrigation System Defines Difficult Tissue Planes

A readily available, low-cost technology is described to assist in dissecting difficult tissue planes

Role of insulin-like growth factor binding protein-4 in prevention of colon cancer

Insulin-like growth factors (IGFs) are important for the proliferation of cancer cells. One of their binding proteins, known as insulin-like growth factor binding protein -4 (IGFBP-4) is well known for its inhibitory action on IGFs in vitro. We assessed the effect of IGFBP-4 in prevention of development of colon cancer in vivo

The Acute Abdomen -Commonly Missed And Mis-diagnosed Conditions: Review The Acute Abdomen -Commonly Missed And Mis-diagnosed Conditions: Review

Abstract The varying presentations of acute surgical conditions make diagnoses often challenging. The commonly missed or misdiagnosed surgical conditions include acute appendicitis, testicular torsion, mid-cycle ovarian pain, femoral hernia, rectus sheath haematoma, diaphragmatic injury, aortic aneurysm and ischaemic bowel. This article provides a review of the literature on commonly missed and misdiagnosed conditions in the acute abdomen which are particularly important for junior surgical trainees

Value of repeating amylase levels in abdominal pain

Rajaraman Durai1, Alexandras Uzkalnis21Specialist registrar, 2Consultant surgeon, Department of Surgery, University Hospital Lewisham, London, SE13 6LH, UKSerum amylase and lipase are commonly used tests for diagnosing pancreatitis. Serum amylase level is usually high in the early days of pancreatitis which subsequently decreases. Serum lipase is not routinely available in every hospital. We report an unusual case of pancreatitis where amylase was normal initially then it began to rise

Laparoscopic perforostomy for treating a delayed colonoscopic perforation: Novel approach

Introduction: With the implementation of bowel cancer screening programmes, more and more colonic polyps are detected, requiring hot biopsies or resections with an attendant risk of perforation. Laparoscopy is increasingly performed for assessing colonoscopic perforations, usually repaired by stitching or stapling, which is associated with a risk of a leak from the suture line. Case Report: We describe a novel approach of laparoscopic exteriorisation of a delayed colonoscopic perforation which resolved without any further intervention. Discussion: Laparoscopic perforostomy is an alternative minimally invasive laparoscopic approach which respects all the rules by allowing a single-stage procedure including thorough toilet with defunctioning and diversion

Laparoscopic perforostomy for treating a delayed colonoscopic perforation: Novel approach

Introduction: With the implementation of bowel cancer screening programmes, more and more colonic polyps are detected, requiring hot biopsies or resections with an attendant risk of perforation. Laparoscopy is increasingly performed for assessing colonoscopic perforations, usually repaired by stitching or stapling, which is associated with a risk of a leak from the suture line. Case Report: We describe a novel approach of laparoscopic exteriorisation of a delayed colonoscopic perforation which resolved without any further intervention. Discussion: Laparoscopic perforostomy is an alternative minimally invasive laparoscopic approach which respects all the rules by allowing a single-stage procedure including thorough toilet with defunctioning and diversion