ABSTRACT
An internal hernia is any protrusion of a solid organ or a hollow viscus through a defect within the abdominal cavity. Paraduodenal hernias are rare, but are the most common variety of internal hernias. We present a rare case of a left sided paraduodenal hernia in a 26 years old otherwise healthy male who presented in emergency department with intermittent colicky upper abdominal pain. Left paraduodenal hernia was diagnosed pre operatively in a computer tomography scan. Hence patient was offered a laparoscopic repair. Our search via online search engines revealed very few case reports of Paraduodenal hernias which were repaired laparoscopically. We believe that in expert hands, paraduodenal hernias should be managed with laparoscopic technique as it significantly reduces morbidity and hospital stay.
ABSTRACT
Diaphragmatic hernia (DH) usually occurs in childhood; however, in adult it is uncommon. Most common aetiology of DH in adult is trauma while spontaneous DH is a rare entity accounting for <1%. The management is primarily surgical repair in the form of open or laparoscopic approach; the later has been associated with low morbidity, mortality and excellent long term outcomes with low rate of recurrence. In this case series, confirmation of the diagnosis was done by CT scan and by laparoscopy in all the patients; laparoscopic repair was performed in all the patients along with thoracoscopic aid in two cases. We found that minimal access techniques can be safely done in DH; in conditions when the herniated content are difficult to get reduced laparoscopically alone, a simultaneous thoracoscopy has helped in great deal in reducing the content and completing the procedure entirely by minimal access techniques. This gives all the advantages of minimally invasive approach like less postoperative pain, shorter hospital stay, quicker recovery and low recurrence rate; provided tissue repair is done in tension free manner by an experienced laparoscopic surgeon.
ABSTRACT
Background: Cereal venous sinus thrombosis (CVST) is the formation of blood clot in the dural venous and/or sinuses, which drain blood from the ain. It is one of the commonest causes of stroke in young. In most cases it hypercoagulable factors are responsible for it. Materials & methods: prospective observational hospital based study in the department of Neurology, S.C.B. Medical College & Hospital, Cuttack, odisha from October 2015 to September 2017. Those patients with diagnosis of CVST with magnetic resonance imaging and venogram confirmation with thrombophilia profile were included in the study. Thrombophilia assay was done. They were treated with recent guidelines. All the data were analyzed according to spss software version 20.0. Results: Total 24 patients did the profile. Most common age group was 21–40 yrs. Protein s was the most common factor. Transverse sinus was the most common sinus. Multifactorial thrombofilia patients were more resistant to therapy. Conclusion: All the CVST patients must be exposed to thrombophilia profile assay. It will not only help treatment of the disease but also it will help in prognosticate the outcome. In our area protein S deficiency is the most common factor abnormality. Further large studies are needed to obtain further knowledge about the factors and their clinicoradiological correlation.