Pregnancy-associated ectopic decidua of the appendix.

Ectopic decidual transformation is a well-documented phenomenon that occurs most often in the ovary and cervix but also presents on the serosal surfaces of abdominal or pelvic organs. Although generally asymptomatic, ectopic decidua is a rare cause of right iliac fossa pain and acute appendicitis.

Conservative treatment of a cervical thoracic duct cyst: a case report.

Cysts of the thoracic duct are uncommon entities that can occur in the abdominal segment, the cisterna chyli, the thoracic segment and the cervical segment of the thoracic duct. The rarest presentation is in the cervical segment, with only seventeen cases reported in English literature. The diagnosis can be made by puncture and with the use of computed tomography or ultrasonography. The cystic fluid always contains an excess of T-lymphocytes and triglycerides. Except for two cases, all reported cervical thoracic duct cysts were surgically treated by excision and ligation of the lymphatics connected to the cyst. We present a case of a successful non-operative treatment of a cervical thoracic duct cyst that was resolved by repeated aspiration and dietary changes only.

The laparoscopic resection of a benign stromal tumour of the duodenum.

A 72-year-old-female presented intermittent retrosternal pain, heartburn and dysphagia. Computerized CT-Scan showed a large mass with a cross-sectional diameter of 5 cm at the lateral side of part II of the duodenum. The preoperative histology was unclear. The tumour was successfully removed by laparoscopic approach.

Thoracoscopic-assisted pulmonary resection in lung cancer.

BACKGROUND: Thoracoscopic-assisted pulmonary resection for lung cancer is controversial. The appropriateness of this approach has to be compared with the golden standard of an open resection. METHODS: This study consists of 66 patients with a clinical stage 1 disease. A thoracoscopic exploration was executed in 41 patients. Only in 16 cases was a thoracoscopic resection finally possible. The clinical and pathological TNM classification, the histological types and the surgical procedure are reported. The reasons for conversion are documented. RESULTS: To investigate the appropriateness of the thoracoscopic approach we evaluated only the pathologically proven stage 1 disease in both groups. Postoperative complications, hospital stay and survival are compared. CONCLUSION: Until now we can conclude that there is no adverse effect on survival because of the thoracoscopic approach.

The laparoscopic approach of a torsion of a benign mature ovarian teratoma: a case report and review of the literature.

Benign mature teratomas account for approximately 10-15% of all ovarian neoplasms. Many patients with these dermoid cysts are asymptomatic. The most frequent complication is torsion of the teratoma (in 3,5% of the cases). In a 26-year female patient admitted for severe, acute abdominal pain, a computerized abdominal tomography in accordance with the clinical characteristics of the abdominal examination, was highly suggestive for a torsion of a teratoma. The diagnose was confirmed by a celioscopic operative approach and the teratoma with the left tubo-ovarian complex was successfully removed laparoscopically.

Thoracoscopic assisted lobectomy.

The advances in endoscopic capabilities expanded the potential role of laparoscopic and thoracoscopic surgery. The introduction of safe linear stapling devices made thoracoscopic assisted segmental lung resections possible. Because of the postoperative advantages of a thoracoscopic operation, a technique for thoracoscopic lobectomies was developed. Three case reports are presented using the same technique. The first two cases report a right lower lobectomy and the third case a bilobectomy, right middle and lower lobe.

Chronic small bowel obstruction due to intestinal malrotation in the older child: an often missed diagnosis.

A case of chronic small bowel obstruction due to intestinal malrotation in a 13.5-year-old girl is reported. The importance of the patient's history revealing the recurrent character of the symptoms, and of different radiological features are emphasized, in order to prevent late diagnosis. Diagnosis of psychogenic disorder is only retained after exclusion of all organic anomalies. At surgery the bowel is placed in the primitive position of the non-rotated gut, after reduction or resection of the volvulus, if present.

An uncommon breast tumour: the malignant eccrine spiradenoma. A case report.

Eccrine spiradenoma is a benign tumour originating from cutaneous sweat glands. It rarely develops into a malignant tumour. A long-standing cutaneous nodule begins to enlarge rapidly. The growth is often associated with an ulceration and a change in colour. The definitive diagnosis is made after a biopsy with examination of the entire specimen in search for foci of malignant development. The appropriate therapy consists in a wide local excision, with resection of the clinically suspicious lymph nodes. Irradiation of the resection site can be useful to prevent local recurrences. The role of chemotherapy is not yet clearly defined.

[Surgical treatment of reflux esophagitis using Angelchik's ring prosthesis]. / De heelkundige behandeling van reflux oesofagitis met de ringprothese van Angelchik.

Surgical treatment of reflux oesophagitis with the Angelchik prosthesis. Between 1 January 1981 and 30 June 1982 we operated on 18 patients with symptomatic gastroesophageal reflux. We studied our patients clinically before and after surgery, with barium meal, endoscopy and oesophageal biopsy. After surgery all patients were able to discontinue conservative treatment. Two patients needed to have the prosthesis removed because of perforation in the stomach and two patients needed a reinterventive because of loosened knots. The frequency of the complications, particularly of gastric perforations, prevents us to recommend the use of this device in a generalized matter.

Transthoracic vagotomy for recurrent peptic ulcer after gastrectomy. An appraisal of fifteen years experience.

The case records of 38 patients operated for recurrent ulcer following partial gastrectomy were examined. They all underwent a transthoracic vagotomy. Two patients died during follow-up, one because of a gastro-intestinal bleeding 14 days after operation and one following a psychiatric disorder (vital depression) three months after his second intervention. According to Visick's grading overall results are very good in 89%, moderate in 5.5% and disappointing in 5.5%. These figures indicate that transthoracic vagotomy is the treatment of choice for recurrent ulceration after partial gastrectomy.

The management of abdominal wall stomata: skin protection, peristomal wound healing and support for the collecting bag. A multi-center study.

The specific properties of Stomahesive tested in 116 stomal and 20 fistulous patients render it really useful in stomatherapy where it increases the comfort of the patients: 1. it offers an excellent peristomal skin protection whatever the nature of the stoma or origin of the fistula; 2. it promotes rapid healing of skin lesions, even in ileostomy, transverse colostomy, ureterostomy and fistula patients; 3. it ensures an effective degree of impermeability; 4. it provides a large base for adhesion of the collecting bag; 5. it can be kept on for about 6 days in most cases; 6. The local tolerance is excellent (Acta chir. belg., 1977, 76, 533-537).

[Ureteral obstruction secondary to aortic femoral by-pass (author's transl)]. / Ureterobstructie na aortafemorale by-pass

We have presented 3 cases of ureteral obstruction secondary to aortic femoral by-pass grafting. This complication has not been frequently reported and we feel that it may be more common than recognised. In all the other published cases the ureter was passing behind the prosthesis but the authors present a surgically proved case where the ureter lies in its normal position. They also prefer the aseptic vascular procedures for reconstruction.