Implantable venous access devices are routinely used, but they are not without complications. A 4-year-old male child with B cell acute lymphoblastic leukaemia was planned for chemotherapy. Chemo port was accessed through the right internal jugular vein. Check X-ray was done, which showed the correct placement of the catheter. Two months after chemo port insertion when the patient underwent chemotherapy, he developed a fever and he was started on intravenous antibiotics. On the next two admissions, the patient had a fever with chamber site oedema for which culture was done, which revealed Pseudomonas and Candida, which responded to antibiotic and antifungal therapies. In the successive admission, the patient had immediate local oedema on injecting chemotherapy. Exploration was done, which revealed chamber base perforation. It is an infrequent complication and has been reported in only three studies.
Complications at the gastrojejunal anastomosis site after a bypass procedure is challenging in terms of diagnosis, therapy and prevention. Complications most frequently encountered are marginal ulcer, bleeding and stenosis, while perforation secondary to ulceration at anastomosis site is very rare and seldom reported. Direct exposure of gastric acid is the important cause of ulcer formation which may get further complicated by the use of NSAID's, alcohol intake and smoking. We report a case of 47-year-old male who developed perforation at the gastrojejunal anastomotic site of old gastrojejunostomy for peptic ulcer disease.
Laparoscopic cholecystectomy has been the most widely accepted modality of treatment for patients with gall bladder disease. With time and increasing experience laparoscopic cholecystectomy is now being successfully attempted to treat almost all benign gall bladder pathology and their complications. One such uncommon infrequent complication of cholecystolithiasis is the cholecystoenteric fistula. Management of cholecystoduodenal fistula was traditionally performed by open method. With increasing newer laparoscopic techniques and advancement in the field, cholecystoduodenal fistula, an uncommon clinical entity is now being successfully treated via laparoscopic approach. It is feasible and safer than the conventional open approach in experienced hands, thus decreasing the overall morbidity and mortality attributed to the condition. We report a case of cholecystoduodenal fistula treated successfully by laparoscopic approach using an Endo GIA stapler.
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