Abscess of the ligamentum teres is one of the rarest causes of acute abdomen and causes severe dilemma and real challenge in clinching the diagnosis. A 69-year-old lady with severe upper abdominal pain with history of gall stones underwent MRI upper abdomen and was diagnosed as abscess of the ligamentum teres. There are only very few reported cases of this entity in the literature.
Background: Conventionally, VSD are repaired with synthetic patch (Dacron/Goretex). Recently, we began using glutaraldehyde treated autologous patch to repair VSDs. We review our experience.Methods: 45 patients underwent VSD closure from July to September 2005. The age range was 5 months to 12 years (median 4 years). The mean weight was 12.5 kg. There were 15 females and 30 males. 25 patients had isolated VSD, 15 had associated TOF and 5 had DORV. A strip of pericardium was harvested, stretched out on thin cardboard paper to avoid wrinkles, and secured with clips. It was fIxed by immersion in 0.6% glutaraldehyde for about 20 minutes and then washed out with normal saline. A continuous suture technique was used to repair the defect The patch was easy to handle during VSD closure.Results: There was no post operative mortality. Immediate post operatively, trivial shunts were seen in 6 patients on echocardiogram. No patient had significant residual VSD.Conclusions: Autologous glutaraldehyde-treated pericardial patch is a safe and cost effective alternative to synthetic patch for VSD repair. It is easily available and does not require sterilization. Further follow-up is required to assess its long term efficacy.
26Difficult weaning from ventilator due to anomalous origin of right upper lobe bronchus in a case of single stage unifocalization
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