Schistosomal appendicitis: a rare cause of a common surgical condition.

Despite the prevalence of schistosomiasis across the world, appendicitis secondary to schistosomiasis is a rarely encountered presentation even in endemic areas, let alone in developed Western countries. We report a case of a 34-year-old male in Australia with acute appendicitis and subsequent histopathology, demonstrating the presence of schistosome ova. The case highlights the difficulties in pre-operative diagnosis of this entity and the importance of its recognition for the practising surgeon, especially in the developed world, where this rare condition may be encountered because of changing global travel and migration patterns.

Oesophageal squamous papilloma: a rare finding on oesophago-gastro-duodenoscopy with malignant potential.

Oesophageal squamous papillomas (OSPs) are rare epithelial lesions, recognized to be benign but with reported malignant potential. We report a case of a 40-year-old female with chronic vomiting, subsequently found on oesophago-gastro-duodenoscopy to have two mid-oesophageal sessile polyps, the largest of which measured 10 mm. These were endoscopically resected with histopathology confirming an OSP without evidence of dysplasia or malignancy. The case under consideration reports the current literature on OSPs regarding their aetiology, malignant potential and optimal management.

Laparoscopic Ladd's procedure: a case report and review of the literature on patient selection for an appropriate surgical approach.

Intestinal malrotation is a rare condition which is managed surgically with the Ladd's procedure. We report a case of an adult male presenting with symptomatic intestinal malrotation which was successfully treated with a laparoscopic Ladd's procedure. While traditionally performed with a laparotomy, the case highlights the emerging evidence in the literature supporting the laparoscopic approach and explores factors affecting patient selection for an appropriate surgical approach.

Omental lipoma: a rare cause of a giant intra-abdominal mass.

Primary tumors of the omentum, let alone omental lipomas, are rare causes of a large intra-abdominal mass. We report a case of an adult male presenting with an intra-abdominal mass, representative of a giant omental lipoma radiologically, confirmed on histopathology after complete resection at laparotomy. The case highlights the preoperative workup of a suspected omental lipoma, including the utility of various radiological modalities in differentiating from malignant pathologies, and anatomical characterization of the lesion for surgical planning.

Anterior Longitudinal Ligament Reconstruction to Reduce Hypermobility of Cervical and Lumbar Disc Arthroplasty.

STUDY DESIGN: Retrospective case series. PURPOSE: This study aims to present the early clinical and radiological outcomes of anterior longitudinal ligament (ALL) reconstruction following disc arthroplasty. OVERVIEW OF LITERATURE: Although cervical and lumbar disc arthroplasty have entered the clinical setting, there are still concerns regarding the short and long term complications arising from hypermobility of current prosthesis designs. Reconstruction of the ALL is a potential solution to disc arthroplasty hypermobility. METHODS: ALL reconstruction following disc arthroplasty have been performed by the senior author over a 24 month period. Ligament replacements used include allograft and synthetic, ligament advanced reinforcement system (LARS) ligaments. Methods of fixation used include titanium staples, bone anchors and suture fixation. Radiological follow-up pre- and postoperative Oswestry disability index, Neck Disability Index, Patient Satisfaction index scores were recorded on all patients. RESULTS: A total of 18 ALL reconstructions were performed. There have been no cases of early complications, revision surgery for recurrent symptoms or implant failure. Of the 6 patients receiving a minimum of 15 months follow-up, 4 patients received an allograft, 2 patients received the LARS ligament. Favourable, postoperative clinical and radiographic outcomes have been demonstrated. CONCLUSIONS: ALL reconstruction following cervical and lumbar disc arthroplasty is a promising solution to addressing non-physiological kinematics of current disc arthroplasty devices. Randomized, controlled studies with larger study samples and long-term follow-up are required to establish these conclusions.

Image-Guided Lateral Mass Osteotomy for En Bloc Resection of Cervical Ewing Sarcoma: A Technical Note.

BACKGROUND: En bloc resection of Ewing sarcoma in the cervical spine according to Enneking's principles is technically challenging owing to the proximity of important neurovascular structures, the complex local anatomy, and the biomechanical instability of radical resection. The rarity of Ewing sarcoma and variability of its presentation justifies ongoing exploration and compilation of the surgical nuances and subtleties of en bloc resection in the cervical spine. CASE DESCRIPTION: We present a 34-year-old male with Ewing sarcoma of the neck who underwent successful en bloc resection using a novel technique of splitting the laminae and osteomizing the lateral masses under imaging guidance. CONCLUSIONS: This novel and successful approach of en bloc resection in the cervical spine can add to the spinal surgeon's repertoire when dealing with complex cervical tumor masses.

Oblique Lumbar Interbody Fusion: Technical Aspects, Operative Outcomes, and Complications.

OBJECTIVE: Anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) are commonly used approaches for lumbar spine fusion surgery, each with their own unique advantages and disadvantages. ALIF requires mobilization of the great vessels and peritoneum, and dissection of the psoas muscle in the LLIF technique is associated with postoperative neurologic complications in the proximal lower limb. The anterior-to-psoas (ATP) or oblique lumbar interbody fusion (OLIF) technique is the proposed solution to accessing the L1-L5 levels without the issues encountered with ALIF and LLIF. In this review, the technical nuances, operative outcomes, and complications with the ATP/OLIF technique in the current literature are summarized. METHODS: A systematic search of the literature was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data collected included operative time, blood loss, postoperative hospital stay, and complications, which were then pooled together. RESULTS: From the 16 studies selected, the mean blood loss was 109.9 mL, average operating time was 95.2 minutes, and mean postoperative hospital stay was 6.3 days. Fusion was achieved in 93% of levels operated. Incidence of intraoperative and postoperative complications was 1.5% and 9.9%, respectively. Transient thigh pain and/or numbness and hip flexion weakness occurred in 3.0% and 1.2% of patients, respectively. CONCLUSIONS: Early results on the ATP/OLIF technique are promising and warrant further investigation with well-designed prospective randomized studies to provide high-level evidence of the potential advantages over the ALIF and LLIF approaches.