Introduction: Schwannoma is a rare tumor among pancreatic neoplasms. Schwannomas vary in size, and most of them are cystic, mimicking pancreatic cystic lesions. Generally, a definitive diagnosis is made at the time of histological analysis. The mainstay treatment is surgical resection.
Multiple tissue samples were obtained during emergent abdominal surgery in 4 patients with coronavirus disease 2019 (COVID-19) to examine for tissue involvement by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first patient underwent a laparoscopic cholecystectomy for gallbladder empyema and died from severe respiratory failure. The second patient with Crohn disease underwent emergent laparotomy for a perforation in the terminal ileum and recovered. The third patient underwent an open appendectomy and recovered. The fourth patient underwent emergent laparotomy for a perforated peptic ulcer and died from sepsis. Although the SARS-CoV-2 RNA was found in the feces of 3 patients and in the duodenal wall of the patient with perforated peptic ulcer, real time reverse transcriptase polymerase chain reaction (RT-PCR) examination of abdominal fluid was negative for the virus. The RT-PCR did not detect viral RNA in the wall of small intestine, appendix, gallbladder, bile, liver, and urine. Visceral fat (omentum) and abdominal subcutaneous fat of 4 patients were also not infected with the SARS-CoV-2. Although this limited experience did not show direct involvement of abdominal fluid and omentum, assessment in large series is suggested to provide answers about the safety of abdominal surgery in patients with COVID-19.
Introduction: Infrared photocoagulation (IRC) was introduced as a mainstay procedure for treatment of hemorrhoids. The present study aimed to compare the clinical efficacy of IRC compared to closed hemorrhoidectomy. Methods: Forty patients suffering grade-3 hemorrhoid that referred to the surgery clinic at Imam Hossein hospital in Tehran in 2013 were randomly assigned to groups treated with the IRC modality or Ferguson's closed hemorrhoidectomy method. The patients in the 2 groups were followed-up for the first 24 hours after surgery and 8 weeks later. Postoperative pain was assessed using visual analogue scale (VAS) at three time points of 24 hours, 2 weeks and 8 weeks after operation. Results: Regarding bleeding, its overall prevalence was 5.0% in the IRC group and 30.0% in the hemorrhoidectomy group, which was significantly less prevalent in the IRC group. Notably, the IRC group had a lower mean postoperative pain score compared to the hemorrhoidectomy group. Time of return to work was significantly shorter in the IRC group; no difference was found in the mean duration of hospital stay, and recurrence rate across 2 groups. Conclusion: IRC procedure is safer than closed hemorrhoidectomy with lower postoperative pain severity, less secondary bleeding, and leads to earlier return to work in patients with hemorrhoid.
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