Giant adominal wall hernia in a patient with cryptogenic cirrhosis

Abdominal wall hernias are common problems found in patients with cirrhosis because of persistently high intra-abdominal pressure. When abdominal hernias are neglected in such patients, they may become larger and could result in cosmetic problems and pressure effects that are also difficult to treat. We found a voluminous mass in the anterior abdominal wall of a 40-year-old patient with cirrhosis. The patient was operated on for acute cholecystitis 12 years earlier. Abdominal computed tomography revealed an epigastric hernia presenting as a grossly distended hernia sac filled with serous fluid and intestinal loops. The patient was not operated on and was discharged with sodium-restricted diet and diuretics

Fulminant hepatic failure due to primary hepatic lymphoma: a case report

Primary hepatic lymphoma is a rare malignancy usually presenting with symptoms of fever, hepatomegaly, jaundice and weight loss. This picture mimics infectious and inflammatory disorders and thus delays the diagnosis. Here, we present a 47-year old man with prolonged fever who underwent several investigations and, in the meantime, developed fulminant hepatic failure before the diagnosis could be reached

Oral omeprazole in patients undergoing combination endoscopic therapy for bleeding peptic ulcers A: prospective double-blind randomized study

Endoscopic therapies can decrease the morbidity of patients with high risk peptic ulcer. The aim of this study was to evaluate the beneficial effects of oral omeprazole therapy in patients with bleeding peptic ulcer who received combined endoscopic treatment [epinephrine injection and Argon Plasma Coagulation]. Eighty six patients with bleeding from gastric, duodenal or stomal ulcers and endoscopic stigmata of recent bleeding were enrolled in our study. All patients received injection of epinephrine [1:10,000] and also their ulcers were treated with Argon Plasma Coagulator. The patients then randomly assigned to receive oral omeprazole [40 mg every 12 hours] or placebo. Five [11.6%] of 43 patients in the placebo group had rebleeding; but no rebleeding was detected among 43 patients in omeprazole group [p= 0.05]. One patient in the Placebo group underwent surgery for control of his rebleeding; but none of the patients in omeprazole group needed surgery. One patient in the placebo group and none of the patients in the omeprazole group died. The average hospital stay was 5 days in the omeprazole group and 5.8 days in the placebo group. Addition of oral omeprazole to combined endoscopic therapy significantly reduces recurrent bleeding rates