Surgical Repair

Background: If medical treatment of obesity fails and if surgical gastroplasty is not indicated, insertion of an intragastric balloon may represent an intermedi-ate modality. Methods: Two patients are reported in whom a bal-loon was placed for weight reduction before elective surgery: 1) ...

The Bentall procedure is a surgical repair of an ascending aortic or aortic root aneurysm in combination with aortic valve disease. Less commonly, it is used to repair aortic dissection affecting the aortic root and valve. During the procedure, a composite aortic valve graft is used to replace the proximal ascending aorta and aortic valve. The procedure is performed through a median sternotomy during cardiopulmonary bypass. In this modification of the original procedure, coronary artery circulation is maintained by removing a full-thickness "button" of aorta surrounding the coronary ostia, making it easier to implant the proximal end of the coronary arteries into openings made in the aortic vascular graft.

We describe a new video-assisted operative technique for correction of pectus carinatum (PC) using a modified Nuss procedure. A new design of the steel bar was developed, so that it could be introduced and placed in a suitable position through very small skin incisions. Substantial modifications were introduced in the bar length and shape aimed at facilitating insertion and subsequent

We describe a new video-assisted operative technique for correction of pectus carinatum (PC) using a modified Nuss procedure. A new design of the steel bar was developed, so that it could be introduced and placed in a suitable position through very small skin incisions. Substantial modifications were introduced in the bar length and shape aimed at facilitating insertion and subsequent

Mohammed HA Al-Akeely, MBBS, CABS,1 Mohammed K. Alam, MBBS,1 ... 1 Kamran Khalid, 1 Ibrahim Al-Teimi, MBBS, 2 ... 1Department of General Surgery, College of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Kingdom of Saudi Arabia ...

To report ocular perforation that occurred during retrobulbar injection in 7 highly myopic eyes. Seven patients with a diagnosis of globe injury during retrobulbar injection for ocular anesthesia before cataract surgery were managed by vitreoretinal surgery. All injections were performed by ophthalmologists. The surgeon recognized the perforation in 4 cases at the time of injection. The preoperative vision was hand motion perception in 4 eyes and light perception in 3 eyes. All patients underwent vitreoretinal surgery because of the presence of vitreous hemorrhage and/or retinal detachment diagnosed by funduscopy or ultrasonography. At the time of surgery, all eyes had vitreous hemorrhage and 4 eyes had rhegmatogenous retinal detachment. The number of vitreoretinal procedures performed was: 1 procedure in 4 patients, 2 procedures in 2 patients, and 3 procedures in 1 patient. The period of follow-up ranged from 4 months to 4 years, averaging 20 months. At the end of the follow-up per...

Morgagni hernia is a rare diaphragmatic hernia usually due to congenital defects in the diaphragm. It is rarely associated with cardiac anomalies, most commonly atrial small (ostium secundum) or ventricular septal defects. We report a rare case of Morgagni hernia occurring in association with Large ASD Secondum and Sever PHT mimicking a severe congenital heart disease in a newborn and the lack of awareness of the delayed presentation of Morgagni’s diaphragmatic hernia cause delayed of diagnosis.
Clinical Discussion: Our patients, a one-month-old girl, present with cyanosis and shortness of breath admitted were admitted with complaints of chronic cough and repeated chest infections treated accordingly and discharge in good condition. Readmitted after 1 week with similar presentation but her symptoms get worse by time ,patient admitted to PICU as aspiration Pneumonia, patient during the admission diagnosed with Congenital heart disease large ASD (ostium secundum) and Sever PHT, by echocardiography .she was still lethargic hypotonic, low birth weight , she had intermittent cyanosis inspit treating the chest infection was investigated, thoroughly later she was diagnosed with Morgagni Hernia after repeating CT chest with contrast two times. Repair of hernia was done and outcome was good inspite she was diagnosed late at age of 2 years. pulmonary hypertention treated ASD closure by double device.
Conclusion: Morgagni’s CDH is a rare malformation, which is difficult to diagnose by even the most experienced physicians.
• Compression of the heart by the bowel might have led to the incorrect diagnosis of congenital heart disease. Even in this era of highly sophisticated diagnostic tools,
• The basic idea of reporting this case is its rarity in incidence and dilemma in diagnosis. It highlights the difficulties in diagnosis, prompting a need for high index of suspicion when assessing patients with respiratory distress and with symptoms suggestive of gastrointestinal obstruction. A missed diagnosis can lead to life-threatening complications such as obstruction or strangulation which warrants early surgical intervention. • The basic idea of reporting this case is its rarity in incidence and dilemma in diagnosis. It highlights the difficulties in diagnosis, prompting a need for high index of suspicion when assessing patients with respiratory distress and with symptoms suggestive of gastrointestinal obstruction. A missed diagnosis can lead to life-threatening complications such as obstruction or strangulation which warrants early surgical intervention.

Primary aorto-duodenal fistula · Radiotherapy complication · Gastrointestinal bleeding Primary aorto-duodenal fistula (PADF) is a rare condition that may result in rapid exsanguination if untreated. PADF due to radiotherapy appears to be extremely rare with only a few cases reported in the medical literature. We report the case of a 61-year-old man who presented with massive gastrointestinal bleeding 25 years after surgery and radiotherapy for seminoma of the testicle and was successfully treated at our institution. We also review the literature on this very uncommon condition. A Medline search was conducted for the period from 1966 to June 2006 to identify case reports of PADF following radiotherapy. Only 7 cases of PADF due to radiotherapy were identified in addition to our own, 4 males and 3 females, aged 40 to 73 years, all treated for various forms of abdominal malignancies. The latency period ranged from 2 weeks to 25 years. None of the aortas were aneurysmatic. One patient di...

The hip labrum has many functions, including shock absorption, joint lubrication, pressure distribution, and aiding in stability, with damage to the labrum associated with osteoarthritis. The etiology of labral tears includes trauma, femoroacetabular impingement (FAI), capsular laxity/hip hypermobility, dysplasia, and degeneration. Labral tears present with anterior hip or groin pain, and less commonly buttock pain. Frequently, there are also mechanical

Achilles tendon rupture in the dog is a common traumatic lesion. An accurate evaluation of etiology, grade of the lesion with or without loss of tendon substance, and time elapsed from the trauma can guide the surgeon in choosing the best surgical technique. Moreover, the healing process after a tendon injury is usually difficult and uncertain because the prognosis is influenced by extent of trauma, time elapsed between the trauma and its treatment and low tendon vascularization. However, the rapid development of tissue engineering and regenerative medicine could soon result in the development of scaffolds with bioactive proteins that can direct the healing process toward complete tendon regeneration without fibrotic tissue development.

Meningoencephalic herniation into the middle ear is a rare condition that can be life threatening for the patient due to eventual infective intracrunial complications. It is characterized by a bony and dural defect localized in the tegmen through which meninges and encephalic tissue can herniate. Meningoencephalic hernia of the middle ear can appear as an insidious complication of Chronic mastoiditis (infective) and its surgery, trauma or spontaneous. High resolution computed tomography (CT scan) and Magnetic resonance imaging (MRI) must be done to evaluate the extent and the contents of the disease. Early and effective surgical repair, the only appropriate treatment, is necessary to avoid complication and recurrence. Middle cranial fossa, mastoid, combined approaches and obliteration of mastoid; external auditory canal and middle ear are the surgical procedures for the repair of hernias. Various materials viz. fascia/ muscle/fat / cartilage/ bones/ synthetic materials are used. Rec...

Background and Purpose —The fat embolism syndrome (FES) is characterized by the simultaneous occurrence of pulmonary and neurological symptoms as well as skin and mucosal petechiae in the setting of long-bone fractures or their surgical repair. Its pathophysiology is poorly understood, and effective treatments are lacking. We present 5 patients with long-bone fractures in whom in vivo microembolism was detected by transcranial Doppler. Methods —Five patients with long-bone fractures were monitored with transcranial Doppler for microembolic signals (MESs) after trauma. Two patients also had intraoperative monitoring. A TC-2020 instrument equipped with MES detection software was used. Detected signals were saved for subsequent review. Selected signals satisfied criteria defined previously and were categorized as large or small. Results —Cerebral microembolism was detected in all 5 patients and was transient, resolving within 4 days of injury. Intraoperative monitoring revealed an incr...