A mesh overlap of at least 5 cm and fixation of the lower margin of the mesh under direct vision to Cooper's ligaments appears to confer increased strength and durability and contribute to low hernia recurrence rates in patients with suprapubic hernias.
Magnetic resonance imaging (MRI) of the breast is primarily used as a supplemental tool to breast screening with mammography or ultrasound. A breast MRI is mainly used for women who have been diagnosed with breast cancer, to help measure the size of the cancer, look for other tumors in the breast, and to check for tumors in the opposite breast. For certain women at high risk for breast cancer, a screening MRI is recommended along with a yearly mammogram. MRI is known to give some false positive results which mean more test and/or biopsies for the patient. Thus, although breast MRI is useful for women at high risk, it is rarely recommended as a screening test for women at average risk of breast cancer. Also, breast MRI does not show calcium deposits, known as micro-calcifications which can be a sign of breast cancer.
Background Agenesis of gallbladder is a rare congenital anomaly. Variable diagnostic approaches, perioperative management strategies and postoperative follow up protocols provide a dilemma to its correct diagnosis and management.
The aim of this study was to determine the effect of low-pressure pneumoperitoneum and duration of surgery in laparoscopic cholecystectomy on postoperative shoulder tip pain. A total of 100 patients were assigned into two groups depending on the intraperitoneal pressure during laparoscopic cholecystectomy. Group A included patients in whom the intraperitoneal pressure was 13-15 mm of Hg and group B included patients who underwent surgery at 10-12 mmHg. Each group was then subdivided into two subgroups depending on the duration of surgery. In the first subgroup, the duration of surgery was less than 1 h and the next subgroup included patients who took more than 1 h. Presence or absence of shoulder tip pain was recorded within 4 h, at 24 h, and at 48 h. Total number of patients having shoulder tip pain in the lower pneumoperitoneal group was more than the higher pneumoperitoneal group in both subgroups, P values >0.05. More patients in the <1 h subgroup had shoulder tip pain as compared to the >1 h group at both pneumoperitoneal groups, P values >0.05. Shoulder tip pain was most at 24 h and gradually decreased thereafter. In our study, intra-abdominal pressures and shorter duration of surgery were factors unrelated to incidence of shoulder tip pain after laparoscopic cholecystectomy.
Metastatic squamous cell carcinoma of the gastrointestinal tract is relatively uncommon. It is associated with a poor prognosis and behaves more aggressively. We report a case of metastatic growth in the ascending flexure of the colon that had eroded into the anterior abdominal wall muscles and resulted in a large parietal abscess. She had undergone radical hysterectomy followed by radiation therapy for stage II carcinoma of the uterine cervix 14 months back. Ultrasound guided drainage of the abscess was done as an emergency procedure to control the sepsis. After 3 days an extended Right Hemicolectomy with stapled ileo colic anastomosis was done with resection of a part of abdominal wall adherent to the growth with a grossly normal margin. Histopathological examination confirmed metastatic squamous cell carcinoma. She is disease free 2 months after surgery. Surgical management of the metastatic tumour was palliative but necessary to prevent intestinal obstruction in future.
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