Classification of primary and incisional abdominal wall hernias

A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable.Comparative StudyConsensus Development ConferenceJournal ArticleReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Pneumopéritoine diagnostique uniquement au CT scan.

The authors report 3 cases of pneumoperitoneum due to visceral perforation and whose diagnosis was not performed on plain abdominal radiographs. In the 3 cases, pneumoperitoneum diagnosis and laparotomy decision were based on the results of an emergency abdominal CT Scan. Each time, the origin of the pneumoperitoneum was also clearly evidenced. When visceral perforation is suspected, we advice to perform CT Scan of the abdomen if pneumoperitoneum diagnosis has not been made by plain abdominal radiographs. CT Scan is an accurate exam for pneumoperitoneum diagnosis that permits undelayed surgical treatment

Assessment of the optimal timing for early laparoscopic cholecystectomy in acute cholecystitis: a prospective study of the Club Coelio.

The optimal timing for cholecystectomy in patients with acute cholecystitis remains controversial. The aim of this study is to assess prospectively the impact of the duration of symptoms on outcomes in early laparoscopic cholecystectomy (ELC) for acute cholecystitis. The series consisted of 276 consecutive patients who underwent ELC for acute cholecystitis in 2016. The patients were divided into three groups according to the timing of surgery: within the first 3 days (group 1), between 4 and 7 days (group 2) and beyond 7 days (group 3) from the onset of symptoms. The percentage of surgical procedure rated as difficult was respectively: 12% in G1, 18% in G2 and 38% in G3 (p < .001). Accordingly, we observed an increased mean operative time within groups but no significant difference in the conversion rate. We noted a different overall postoperative complication rate within groups, respectively: 9% in G1, 14% in G2 and 24% in G3 (p < .04). The median hospital stay was also different within groups, respectively: 3 in G1, 4 in G2 and 6 days in G3 (p < .001). On univariate analysis, age ≥60, male gender, ASA 3, WBC ≥13.000/µL, CRP ≥100 mg/l and delay between onset of symptoms and surgery were factors statistically associated with increased morbidity rate. On multivariate analysis, the delay was the only independent predictive factor of postoperative morbidity (OR: 1,08, 95% CI: 1.01-1.61, p < .031). Our study confirms that it is ideal to perform ELC within 3 days of symptoms onset and reasonable between 4 to 7 days. We do not recommend performing ELC beyond 7 days because of more difficult procedure and significantly increased risk of post-operative complications

Gastrodiaphragmatic fistula after transabdominal Nissen fundoplication. An unusual complication.

A 60-year-old woman developed a gastrodiaphragmatic fistula as a late complication of transabdominal Nissen fundoplication. For 6 years, she had complained of chest pain and was considered to have pericarditis. At reoperation the fistulous track was found and easily resected. No other causative factor could be identified

Late diagnosis of intestinal malrotation treated with gastrojejunal bypass: A case report

We report the case of a male African patient who presented at day 8 of life with recurrent episodes of proximal small intestine occlusion, which was treated conservatively, because of misdiagnosis. Physical and cognitive development was normal throughout with, however, some episodes of stagnation. At the age of 15 years the recurrence of symptoms, not responding to the current conservative treatment, resulted in severe weight loss with BMI at 11 kg/m2. The oesogastroduodenal barium study disclosed an extrinsic duodenal compression compatible with a congenital duodenal band. Because of the major concerns related to the patient and to the medical environment, jejunostomy for feeding was first performed to improve his weight. A year later the intestinal malrotation was cured by gastrojejunal bypass. The postoperative clinical course was favorable. The patient resumed a normal life and schooling. His BMI is currently 21.5 kg/m2.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

[Assessment of quality of life after antireflux surgery].

The QoL of the patients was greatly improved after antireflux surgery, but remained lower than that of a control group of healthy subjects. Better patient selection should improve the results. In our series, male patients or patients with a high preoperative GIQLI score were the best candidates for antireflux surgery