Liver hydatid cyst rupture into gallbladder and right hepatic duct: A case report.

INTRODUCTION AND IMPORTANCE: Concomitant rupture into the gallbladder and biliary tract is a very rare complication of liver hydatid cyst. PRESENTATION OF CASE: We present the case of a young woman with rupture of liver hydatid cyst into gallbladder and right hepatic duct which was presented with abdominal pain and jaundice. CLINICAL DISCUSSION: While fistulization to the gallbladder is a rare complication of liver hydatid cyst, concomitant rupture of liver hydatid cyst into the gallbladder and biliary tract is very rare. The principle treatment of this condition is surgery with adjuvant anthelmintic therapy. CONCLUSION: Rupture into gallbladder and biliary tract is a rare complication of liver hydatid cyst, where abdominal pain is the most common symptom and surgery is the mainstay of treatment.

Missing intrauterine device migrated to terminal ileum resembling adnexal mass: A case report.

INTRODUCTION AND IMPORTANCE: Although IUD has become more popular in recent years, its migration through uterine perforation is a rare but serious complication. PRESENTATION OF CASE: We present the case of a young otherwise healthy woman with a missing IUD that had penetrated terminal ileum. CLINICAL DISCUSSION: The incidence of uterine perforation after IUD insertion has been reported 1.3 to 1.6 per 1000 insertions. Although a rare complication, it can cause serious problems requiring major surgery. CONCLUSION: Uterine perforation and migration of IUD is a rare but serious complication that should be considered in all missing IUD threads.

Laparoscopic cholecystectomy: review of 1430 cases in Cure International Hospital, Kabul, Afghanistan.

BACKGROUND: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of cholelithiasis in most countries of the world. The objective of this study was to evaluate the outcomes of LC in the surgery department of Cure International Hospital, Kabul, Afghanistan. METHODS: A retrospective study was conducted on 1430 LC cases performed by the general surgery department of Cure International Hospital. Data was collected from patient files and the operation theatre registry for whom LC was performed during January 2008 through December, 2019. RESULTS: Mean age was 45.77 ± 13.45 years (14-90 years), with male/female ratio of 1:4.7. One third (33%) had comorbidities. Most of patients (~ 97%) were classified as ASA grade I and II. Of all patients, 26.8% of males and 13.2% of females had gallbladder inflammation (OR = 2.203, 95% CI 1.56-2.61, P = 0.000). Overall mean duration of anesthesia was 75 ± 25.6 min. The conversion rate to OC was 4.6% (N = 66), most commonly dense adhesions at Callot's triangle (3.8%). The intraoperative complication rate was 17.5% (N = 249), where bile/stone spillage was the most common indication (N = 235, 16.4%). Immediate postoperative complication rate was 2.4% (N = 35). Average length of stay (ALOS) after LC was 2.23 ± 1.43 days (1-19 days). CONCLUSION: This study shows that elective LC can be performed safely in Afghanistan with comparable outcomes in terms of complications, conversion rates, and ALOS to other countries of the region and the world. Proper case selection and careful preoperative evaluation and management can decrease further conversion, intra- and postoperative complications.

Evisceration of small bowel through spontaneous perforation of rectum: Case report and review of literature.

INTRODUCTION: Small bowel evisceration through spontaneous perforation of the rectum is an extremely rare condition in which the small bowel herniates mostly through a defect in the anterior rectal wall. CASE PRESENTATION: We present the case of a 25-year-old otherwise healthy lady who denied any history of rectal prolapse or trauma. DISCUSSION: Small bowel evisceration through rectum is a rare surgical emergency with a mortality rate as high as 42.3%. Apart from trauma, chronic constipation, rectal prolapse, presence of a deep Douglas pouch and a sliding hernia formed by the cul-de-sac have also been described as etiological factors. CONCLUSION: It is extremely difficult to find out the actual cause of "spontaneous" small bowel evisceration, especially in young adults.