Transomental herniation as a mechanism for large bowel obstruction is a comparative surgical rarity. The second such case is presented, together with a brief review of available literature. The pathogenesis of omental foraminae is discussed, and an additional aetiological mechanism is proposed.
In a consecutive series of 310 cholecystectomies performed for gallstones, dissection of the operative area disclosed 75 patients (24%) who had 84 potential anatomic hazards which could have led to a bile duct injury. There were 49 hazards related to the arterial supply, 8 to the position of the Hartmann pouch, and 27 were related to the anatomic features of the cystic duct or of the other extahepatic bile ducts. The practical significance of these hazards in terms of prevention of bile duct injury during cholecystectomy is discussed.
Two cases of disruption of a Celestin tube with distal displacement are described. In each case the tube was removed and the method of treatment is discussed. Regular insertion and retrieval of Celestin tubes using endoscopy is suggested for benign lower oesophageal strictures.
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