[Retroperitoneal rupture of the duodenum].
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The results of 50 laparoscopic transabdominal pre-peritoneal inguinal hernia repairs are reported with a follow-up of 1-4 years. The patientsage range was 16-75 years. Two recurrences occurred. Only few complications were encountered. The procedure was remarkably pain-free, with 18% requiring no analgesia after the operation and 63% requiring no analgesia after discharge from hospital. There was a rapid return to normal activity, with 55% driving within I week of the operation and 84% within 2 weeks. Sixty-three per cent returned to work within 2 weeks of the operation and 71% within 3 weeks. The results show that laparoscopic hernia repair is remarkably pain-free, allows a rapid return to normal activity and has a low recurrence rate.
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AMONG conditions associated with obstruction of the duodenum is the "superior mesenteric artery syndrome,"1seemingly the result of compression of the duodenum by the superior mesenteric vessels. The typical patient is a young adult, usually a woman, with an asthenic body habitus and superimposed weight loss. The symptoms of this condition are the same as those of acute or chronic high intestinal obstruction. On roentgenographic examination or inspection at surgery, dilation and hypertrophy of the first, second, and part of the third portions of the duodenum are found with retained secretions in the stomach and churning peristalsis in the duodenum In our experience, this syndrome is much less common than that reported by Goin and Wilk,2who found one case in 300 roentgenograms of the upper gastrointestinal tract. In a five-year period (1957 to 1962), approximately 38,000 roentgenograms of the upper gastrointestinal tract were made at the Lahey
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Background: Appendicitis is the most common cause of acute abdomen and appendectomy is the most frequent surgical procedure performed in the world in recent times.In the last few years the number of laparoscopic appendectomies performed around the world has dramatically increased.Objective: The aim of the work is to study the acceptance and satisfaction of the patients as regards the laparoscopic approach for management of acute appendicitis and evaluation the results.Patients and methods: It was a comparative study included 100 consecutive patients with acute appendicitis.They were given the options to accept the approach for appendectomy whether open or laparoscopic after discussion the advantages and disadvantages of each approach and the last decision were left to the patient.The study was approved by the medical ethics committee of Aswan University Hospital and a written informed consent was obtained from all patients.Results: The consecutive patients of age ranging from 15-45 years with features suggestive of acute appendicitis were divided into laparoscopic appendectomy group (LA) 70 cases and open appendectomy group (OA) 30 cases, after taking informed consent.LA was done with the help of three trocar/cannulae creating pneumoperitoneum with CO2 whereas OA was performed by McBurney incision.The operating times in OA and LA were 20-70 minutes (mean 30) and 25-95 minutes (mean 55) respectively.Increased doses of analgesics, antibiotics and antiemetics were required in OA, as compared to LA.The mean postoperative hospital stay in LA group was 1.4 days (range 1-3 days) whereas it was in OA group, it was 3.5 days (range 2-6 days).Conclusion: LA is safe and has major benefits like less postoperative pain, decreased wound infection, early hospital discharged, early return to work and a better cosmetic scar than OA.
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Reference has been made by Crile1to the association of hyperthyroidism with gastric and duodenal ulcers, but having had an opportunity from Jan. 1, 1928, to Oct. 1, 1931, to observe 444 ulcers in the gastroenterologic clinic of the Fourth Medical and Surgical Divisions of Bellevue Hospital, my associates and I were unable to detect any patient with an ulcer and a goiter, or with hyperthyroidism. Of the ulcers seen, there were 318 cases in which operation had not been performed and 126 postoperative cases admitted to the clinic. During the past seven years in the thyroid clinics at the New York Post-Graduate Hospital and St. Mark's Hospital, 1,173 cases of goiter have been seen, and in none of these was there a history of pain referable to the stomach or the duodenum. I myself have seen and am familiar with all the aforementioned stomach and goiter cases, and
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Journal Article Delayed diagnosis of malignant tumours missed at laparoscopic cholecystectomy Get access E J Sharp, E J Sharp Gastrointestinal Unit, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK Correspondence to: Miss E. J. Sharp, Gastrointestinal Unit, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK Search for other works by this author on: Oxford Academic Google Scholar R G Springall, R G Springall Gastrointestinal Unit, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK Search for other works by this author on: Oxford Academic Google Scholar N A Theodorou N A Theodorou Gastrointestinal Unit, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 81, Issue 11, November 1994, Page 1650, https://doi.org/10.1002/bjs.1800811129 Published: 14 December 2005 Article history Accepted: 23 April 1994 Published: 14 December 2005
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