Laparoscopic management of pseudomyxoma peritonei secondary to adenocarcinoma of the appendix.

Pseudomyxoma peritonei is a rare disease in which the abdominal cavity fills with thick mucoid material secondary to either benign or malignant conditions. We discuss a case where pseudomyxoma peritonei secondary to adenocarcinoma of the appendix was diagnosed and managed laparoscopically. The laparoscopic approach allows thorough exploration of the abdomen, as well as irrigation and aspiration of the thick mucinous material using a 10-mm suction cannula and the instillation of mucolytic agents such as 5% dextrose solution. Appendectomy or right hemicolectomy can be performed with minimal disturbance of the anterior abdominal wall, thus minimizing future adhesions as well as possible tumor-cell implantation. Intraperitoneal catheters for chemotherapy can be placed easily through the port sites. These measures offer an alternative to radical peritoneal dissection and can be accomplished during the initial laparoscopic exploration.

The straight-leg-raising test: a review*.

A positive unilateral straight-leg-raising sign is routinely interpreted as indicative of a "disc lesion. " A review of the literature was undertaken in an attempt to more clearly illustrate the mechanisms and results of the straight-leg-raising test. It was found that a positive straight-leg-raising test has minimal value in differentiating a patient with herniated disc from other patients with love back pain and sciatica. J Orthop Sports Phys Ther 1981;2(3):117-133.