The incidence and clinical relevance of BDIs during LC in the area of Rome appeared to be stable over the past 8 years and were not influenced by the use of a prospective audit, as compared with a retrospective survey.
As a minimally invasive procedure, bedside diagnostic laparoscopy can be performed in the ICU for hemodynamically unstable patients. It is safe procedure with high diagnostic accuracy for acute intraabdominal conditions that avoids negative laparotomies for unstable patients. The bedside diagnostic laparoscopy procedure is not performed widely, and prospective studies are needed to better evaluate outcome and advantages for critically ill patients.
We describe here the first case in the literature of gallbladder strangulation within an incisional hernia. A patient with a history of rectal cancer operation presented with a "surgical abdomen" and a palpable right upper quadrant mass at the site of the previous colostomy. At surgery, a strangulated gallbladder was found in the subcutaneous tissue. Cholecystectomy was performed, and patient recovery was uneventful. If gallbladder strangulation is suspected, the surgeon should avoid forceful attempts at hernia reduction, as this may cause rupture of the gallbladder and subsequent contamination.
Laparoscopy has been shown to play a crucial role in the management of almost every abdominal emergency, offering, compared with the open approach, an initial diagnostic or explorative tool and a valid alternative in the treatment of the cause of acute abdomen with low morbidity and mortality rates.
Traumatic abdominal wall hernia (TAWH) is a muscle-fascial rupture due to a blunt direct or indirect trauma. High energy trauma is the principal cause of TAWH and they are consequence of car accidents in 50-70% and motorcycle in 15-20%. Similar trauma is described even in infant age following bicycle handlebar trauma (handlebar injuries). Surgical treatment can be urgent or secondary according to the lesions of the patient. Visceral complications secondary to TAWH are extremely rare and they are difficult to treat.
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