In trauma, laparoscopic surgery is commonly utilized as a diagnostic rather than therapeutic measure (1). Its use is often negated because of exigency or limitations in visibility due to haemorrhage. In the present case, a 35-year-old male was involved in a motor vehicle collision and arrived haemodynamically stable with abdominal pain. Abdominal CT revealed liver laceration and active contrast extravasation near the gallbladder fossa. Although angiography with embolization would normally be used, exploratory laparoscopy was performed because of concern for gallbladder injury. The gallbladder was found to be perforated and nearly completely avulsed from the fossa. Laparoscopic cholecystectomy was performed and the patient recovered uneventfully. Gallbladder perforation after trauma is typically an incidental finding during operation for haemorrhagic shock or other indication. Early diagnosis and swift surgical intervention are required, usually via laparotomy. However, when diagnosed preoperatively in the stable trauma victim, gallbladder perforation can be treated successfully with laparoscopy.
Mediastinal abscess can be managed through a variety of both invasive and minimally invasive methods, as determined by location and spread of infection. Thoracotomy remains the gold standard in treatment and is often employed. In the present case, a 54-year-old female with chronic pancreatitis presented with a 1-week history of severe epigastric pain, nausea and vomiting. On CT scan, a large abscess was discovered in the anterior inferior mediastinum. She was taken to the operating room and underwent laparoscopic drainage of the abscess. Laparoscopy represents a novel approach in management of anterior inferior mediastinal abscess.
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