Laparoscopic accessory splenectomy is associated with a low rate of morbidity and a short hospital stay. Despite its success in removing all residual splenic tissue, most patients will probably not enjoy a complete remission.
Between January and April, 1990, three consecutive cases of syringomyelia were treated by percutaneous placement of thecoperitoneal shunts. Two of these patients had undergone craniovertebral decompression earlier at other centers and the third was treated primarily by a thecoperitoneal shunt. In each case, the syrinx was associated with Chiari I malformation, although the clinical presentation was due to a myelopathy. All three patients obtained unequivocal benefit from this simple procedure. Postoperative magnetic resonance images showed considerable shrinkage of the cysts corresponding with clinical improvement.
HighlightsObstructed direct inguinal hernia of sliding variety with bladder being one of its contents is extremely rare and no such case has been reported yet.Though incarceration and even strangulation are extremely uncommon in direct inguinal hernia as compared to indirect inguinal hernia. A long standing direct inguinal hernia may present as acute or sub-acute intestinal obstruction especially in elderly patients. Hence old age with obstructed inguinal hernia might be of direct variety and needs to be repaired immediately.Sliding hernias are diagnosed intra-operatively and is very difficult to identify clinically. Sliding hernias are most common in old age male, of indirect variety on left side according to most literatures.The good operating technique and the use of modern prosthetic materials should allow us to have the same risk of early and late complications after operating on a sliding and non-sliding inguinal hernia.
The world is suffering from the COVID-19 pandemic. Nature has thrown a new challenge towards the healthcare professionals in the form of this new virus. As if that was not enough, we found an extremely rare, interesting and challenging case of mesenteric immature teratoma in this pandemic. Teratomas take origin from totipotent cells and may give rise to neoplasms that contain, in a helter-skelter fashion, bits of bone, epithelium, muscles, fat, nerves and other tissues. They are usually smaller than 10 cm, with cystic space, which is filled with a thick sebaceous secretion containing matted hair and sometimes teeth protruding from a nodular projection, which are unbrushed and may be carious. Though the usual sites are ovaries, occasionally testes, extragonadal sites may be affected. Classically the teratoma originates in the midline position. But in the abdomen, it usually takes the position of one of the paravertebral gutters, as in the present case, perhaps due to its size and weight of the solid part of the constituent elements. Due to its rarity it deserves the attention of the world and therefore we present to u this interesting case.
Kirschner wire is a sharp stainless steel guide wire commonly used in fixation of fractured bone segments. There are case reports of migrated K wire from the upper limb into the spine and chest, and from the lower limb in to the abdomen and pelvis. Here, we present a case report of accidental intra-operative fracture of K wire during percutaneous femoral nailing for sub-trochanteric fracture of right femur, which migrated in to the pelvis when the orthopaedician tried to retrieve the broken segment of the K wire. This case highlights the use of laparoscopy as minimally invasive surgical option.
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