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Displaying all articles - ( Showing 1 to 10 of 222 )
This lesion in a small bowel resection of a 43-year-old man with a recent diagnosis of Crohn’s disease is small bowel adenocarcinoma. Small bowel adenocarcinoma is a rare complication of Crohn’s disease (1). Its ability to mimic acute exacerbation of Crohn’s stresses the importance of a high index of suspicion (2,3). Stricture dilatation should not be done in suspicious obstructive lesions as it could further disseminate tumour cells. Surgical treatment includes segmental small bowel resection with mesenteric lymphadenectomy and primary anastomosis.
1 Canavan C, Abrams KR, Mayberry J. Meta-analysis: colorectal and small bowel cancer risk in patients with Crohn’s
disease. Aliment Pharmacol Ther 2006; 23: 1097–1104.
2 Dossett LA, White LM, Welch DC, Herline AJ, Muldoon RL, Schwartz DA et al. Small bowel adenocarcinoma
complicating Crohn’s disease: case series and review of the literature. Am Surg 2007; 73: 1181–1187.
3 Widmar M, Greenstein AJ, Sachar DB, Harpaz N, Bauer JJ, Greenstein AJ. Small bowel adenocarcinoma in Crohn’s
disease. J Gastrointest Surg 2011; 15: 797–802.
ALPPS technique modification placing a tourniquet in the Cantlie section line and portal vein ligation. Click here to watch the video (Supporting Information) and read the article.
Bullosis diabeticorum is a rare skin manifestation of diabetes mellitus. Historically, the lesions were termed ‘phlyctenar’, owing to their resemblance to blisters caused by burns. Tense painless blisters appear rapidly, most commonly over the feet. The causes of these bullae are unclear, with multiple pathophysiologies hypothesized. The condition should be managed by a multidisciplinary diabetic foot care team. Treatment includes early surgical debridement and topical negative pressure wound therapy. This allows better management of the high levels of wound exudate and therefore helps restore plantar skin integrity.
Julie Brittenden, Bruce Campbell and Dan Carradice discuss the various treatment options available for varicose veins, and their associated quality of life outcomes and cost-effectiveness.
Anastomotic failures in laparoscopic colorectal surgery
Prosthesis-free repair of pectus chest deformity. Click here to watch the video (Supporting Information) and read the article.
This patient was admitted because of a tender irreducible perineal mass. He had an abdominoperineal resection for rectal cancer 9 years previously. The pelvic floor was reconstructed with a gluteal muscle flap. CT shows herniation of small bowel below and behind the sacral bone. At laparotomy, 150 cm of gangrenous small bowel was resected with primary anastomosis. The perineal defect was closed with a biological mesh (porcine collagen). Posterior perineal hernias are only seen as a surgical complication.
Randomized clinical trial of fibrin sealant versus titanium tacks for mesh fixation in laparoscopic umbilical hernia repair. Click here to watch the video (Supporting Information) and read the article.
This woman had polyacrylamide injection breast augmentation 5 years previously. Ultrasound examination revealed large areas of liquid under the breast. At operation, around 200 ml yellowish gel-like substance was squeezed and sucked out from each breast through an areolar incision. Polyacrylamide had been used legally as a human soft tissue filler in China from December 1997 to April 2006, affecting more than 300 000 people. The Chinese government banned the use of polyacrylamide for this application in 2006.
Transanal specimen extraction in robotic rectal cancer surgery. Click here to watch the video (Supporting Information) and read the article.
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