BACKGROUND Portal hypertension is one of the serious complications of cirrhosis of liver leading to unwanted life-threatening variceal bleeding. Loss of liver architecture and fibrosis lead to increased resistance to blood flow through portal vein causing portal hypertension and ultimately leading to ascites, oesophageal varices and splenomegaly. The aim of the study is to find out correlation of portal vein diameter and splenic size with oesophageal varices in cirrhosis of liver. MATERIALS AND METHODS A descriptive study was conducted in Department of Medicine of SCB Medical College, Cuttack and consecutively 50 adult patients of cirrhosis of liver were included in the study. Ultrasonography was done in all patients to measure splenic size and portal vein diameter. Upper GI endoscopy was done in all to record oesophageal varices. RESULTS Out of 50 patients, 34 (68%) had oesophageal varices of various grades and 16 (32%) had no varices. Average portal vein diameter of patients with oesophageal varices was 13.46 ± 0.98 mm and that of patients without varices was 10.91 ± 0.65 mm (p=0.03). Average splenic size in patients with oesophageal varices was 14.7± 0.82 cm and that of patients without varices was 12.2 ± 1.01 cm (p=0.007). Portal vein diameter and splenic size were increased in patients with oesophageal varices than patients without varices.

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Mucocele of the appendix is a rare disease. Clinically, appendeceal mucocele (AM) is an incidental finding or it may mimic appendicitis. In AM, distension of the appendix is caused by mucus, the source of which can be benign or malignant. For the benign disease, appendectomy alone is sufficient but for malignant conditions adjunct treatments are needed. Proper pre-operative evaluation is imperative to distinguish between benign and malignant causes in order to guide the management and reduce complications. For the definitive diagnosis, histology and immunohistochemistry are required. We report an incidental finding of an appendeceal mucocele in a kidney donor during pre-transplant evaluation.

For many decades, D2 procedure has been accepted in the far-east as the standard treatment for both early (EGC) and advanced gastric cancer (AGC). In case of AGC, the debate on the extent of nodal dissection has been open for many years in order to highlight the safety and efficacy of treatment, hence this study. A comprehensive literature research was performed in PubMed to identify studies that compared laparoscopic- assisted gastrectomy (LAG) and open gastrectomy (OG) with D2 lymph node dissection (D2-LND) for treatment of AGC for the last five years. Data of interest were checked and subjected to meta-analysis with RevMan 5.3 software. The pooled risk ratios (RR) and weighted mean difference (WMD) with 95% confidence intervals (CI) were calculated. Overall, 19 studies were included in this meta-analysis. LG had some advantages over OG, including shorter hospitalization (WMD -2.31; 95% CI -4.09 to -0.53; P = 0.01), less blood loss (WMD -120.49; 95% CI -174.27 to -66.71; P < 0.01), faster bowel recovery (WMD -0.55; 95% CI -0.86 to -0.24; P ˂ 0.01) and earlier ambulation (WMD -0.75; 95% CI -1.38 to -0.11; P = 0.02). In terms of surgical and oncological safety, LG could achieve similar lymph nodes (WMD, -0.94, 95% CI, -2.95 to 1.06; P=0.36), a lower complication rate [odds ratio (OR)=0.80; 95%CI, 0.68-0.97; P=0.02], and overall survival (OS) and disease-free survival (DFS) comparable to OG. In conclusion, for AGCs both techniques (LAG and OG) appeared comparable in short- and long-term results. More time was needed to perform LAG; nonetheless, it had some advantages in achieving faster postoperative recovery over OG. In order to clarify this controversial issue ongoing trials and future studies are needed.