A rare form of gastric trichobezoar extending into small bowel with varying gastrointestinal symptoms is known as Rapunzel syndrome. A case history of 6 years old boy is described. This is the twelfth patient with Rapunzel syndrome in the literature.
We reviewed our experience of hepaticoduodenostomy done for choledochal cyst from 1982 to 2007 at our center. The aim of the study was to evaluate the efficacy of hepaticoduodenostomy as a mode of biliary reconstruction after surgical resection of choledochal cyst, to look for any complications associated with hepaticoduodenostomy, with review of the literature. A total of 56 patients underwent hepaticoduodenostomy after surgical resection of choledochal cyst, of which 54 patients underwent primary cyst excision with hepaticoduodenostomy and 2 patients underwent redo surgery (hepaticoduodenostomy). Most of the patients had an uneventful postoperative recovery. Early complications were biliary leak in three patients which subsided on conservative treatment. Long-term complication was seen in only one patient who developed anastomotic stricture 18 years after primary resection of choledochal cyst and hepaticoduodenostomy. Hepaticoduodenostomy is a relatively safe procedure with very low complication rates. It requires a single anastomosis and is simple to perform.
The incidence of horseshoe kidney (HK) is estimated at 1 in 400 cases. The occurrence of Wilms' tumor (WT) in a HK is an uncommon event, estimated at 0.4%-0.9% of all WTs. We report a case of WT arising from the isthmus of a HK and review the literature on the subject.
Background: The goal of surgery for colorectal cancer is cure, but post-operative mortality occurs. In evidence-based medicine, knowledge of the estimated risk associated with an operation might be an important factor to consider when a surgeon and patient consider surgery. This study aims to identify co-morbidity and causes of mortality in relation to direct technical complications of surgery.Methods: All consecutive patients who underwent surgery for colorectal cancer were included. Co-morbidity was determined. The postoperative course was studied and cause of death within 30 days was determined. The clinical and pathologic characteristics of patients were recorded by using detailed questionnaire.Results: 50 consecutive patients who underwent surgery for colon and rectal cancer were studied, out of which 3 died (6.45%). Most common cause for mortality was anastomotic leak and faecal peritonitis. 3 patients did not have any co-morbidities. In 14 patients (28%), duration of surgery was <3 hours, while in 36 patients (72%) operative time was >3 hours. No significant association was found between mode of surgery.Conclusions: The knowledge of independent perioperative risk factors responsible would help the surgeons to take the appropriate measures and shorten the stay and reduce post op mortality and morbidity.
An unusual case of a 5-year-old boy with duplication of the glans, a rare variety of diphallia, is reported. The two glandes were arranged one above the other, the dorsal glans had only a blind pit while the ventral glans had a patent urethra with glanular hypospadias. The child also had right renal agenesis and a posterior urethral stricture.
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