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.
We describe a change in practice towards laparoscopic appendicectomy for the treatment of acute appendicitis over a 7-year period. Furthermore, laparoscopic appendicectomy is associated with acceptable morbidity rates.
Intestinal derotation (ID) is a rarely used surgical technique which allows elegant and effective surgical access to the superior mesenteric axis and third and fourth portion of the duodenum. ID proves an extremely useful technique especially in the emergency setting when access to the "surgical soul" is needed. To master this technique the surgeon has to become familiar with the anatomical landmarks of that area along with the embryological background.
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