Background Cholecystectomy is rarely performed in preschool children and limited data exist evaluating the extent of utilization and safety of laparoscopic cholecystectomy (LC) in preschool children. The aim of this study was to investigate the safety and efficacy of LC in preschool children. Materials and methods This study was conducted from May 2013 to June 2017 and included preschool children from 1 to 6 years of age having gallstones and biliary dyskinesia. The parameters which were studied included bile leak, ductal injury, trocar and pneumoperitoneum-related complication, operative time, duration of hospital stay and recovery. Results Thirty-three patients underwent laparoscopic cholecystectomy. There were 19 males and 14 females. The age of patients ranged from 7 months to 6 years with mean age of 3.2 years. Weight of patients ranged from 8-20 kg with mean weight of 10.4 kg. Gallstones were present in 29 patients and biliary dyskinesia in four patients. Operative time ranged from 55-130 min with mean operative time of 73 min. Duration of hospital stay ranged from 24-80 h with mean duration of hospital stay of 28 h. Bile leak occurred in one patient. There was no bile duct injury in this series. Conclusion Laparoscopic cholecystectomy is safe and efficacious in preschool children with gallstones and biliary dyskinesia.
Pulmonary artery pseudoaneurysm (PAPA) is a potentially fatal, albeit rare cause of hemoptysis. With a varied etiology and debatable management, time is the essence in its treatment. We present a case of a post lobectomy PAPA with recurrence of malignancy, managed via endovascular approach in a low resource setting where an ideal hardware was not available.
Abstract:Introduction: Many foods have been implicated in bezoar obstruction especially sun dried apricots, peaches, and prunes. Dried fruits and vegetable being hygroscopic imbibe water, swell in size and cause mechanical small bowel obstruction. We hereby submit our experience of dealing with patients who presented with acute small bowel obstruction (ASBO) due to dried phytobezoars. Materials and methods: This was a retrospective study which was conducted from March 2017 to March 2012. Operative records of the patients with ASBO due to phytobezoars were retrieved from Hospital Records Section. The clinical details, investigative work up, operative findings and intervention and type of bezoars were noted. Results: Over the period of 5 years, 12 patients of phytobezoars were admitted in the department. The mean age of the patients was 1.85 years with 7(58.3%) males and 5 females (41.6.5%). Vomiting was most common and was present in all the patients, bilious in 11 (91.7%). The other features included abdominal pain in 10 (83.3%), abdominal distension in 8 (66.7%), failure to pass stools in 9 (75%), failure to pass flatus in 9 (75%), diarrhoea 16 (25%), bleeding per rectu m 2 (16.6% patients). All the patients were operated in emergency settings within the period of 8 ± 3 hours of admission. There were no significant operative complications and average hospital stay was 5.2±1 days. Conclusion: Dry fruits and vegetables like apricot, turnip and peach can lead to bezoar formation which subsequently leads to acute small bowel obstruction in these infants and young children. We also want to impress upon the treating physicians to keep in mind the probability of phytobezoars obstruction in patients presenting with mechanical ASBO especially in patients from Himalayan regions.
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