Duodenal perforation in giant inguinal hernia.

Large and complicated hernias are doubly challenging; not only must the hernia be treated according to a degree of severity, but it also necessary to prevent compartment syndrome during reintegration of the viscera. Possible complications range from intestinal necrosis to perforation of the hollow organs. We are presenting the rare case of a duodenal perforation in a man with large strangulated hernia.

Hepatic compartment syndrome complicating a right laparoscopic nephrectomy and treated by surgical decompression.

The hepatic compartment syndrome (HCS) corresponds to compression of the intraparenchymal liver tissue (intrahepatic pressure greater than the portal vein pressure, i.e. >10-15mmHg) caused by a subcapsular or intraparenchymal hematoma of the liver. It can lead to reversal of portal flow and hepatic parenchymal necrosis. We report the case of a patient who underwent a right radical nephrectomy by laparoscopy and who presented with HCS due to a subcapsular hematoma of the liver. Emergency decompression of the liver via laparotomy was performed, which allowed rapid clinical and laboratory improvement.

Optimization of extra corporeal enteral prosthesis (ECEP) by selective aspiration of the digestive flow.

Reinfusion is a medical process which collects digestive flow from a proximal stoma to a distal one, in patient who had a post-operative double enteral stoma. This process avoids the risk of under nutrition and frees the patient from a Total Parenteral Nutrition to offset the digestive loss. Most of the previous ways of reinfusion first collect the digestive flow into a bag before instillation. We developed an ambulatory reinfusion pump (ECEP) which had the advantage to collect the digestive flow directly from the proximal stoma and to pump it to the distal one. However, the main risk of such a continuous pumping process is to create mucosae lesions by direct suction. The aim of this study is to up-grade our device by introducing a selective aspiration based on the arrival of digestive flow.

Performance evaluation of the extra corporeal enteral prosthesis (ECEP) vs a By-Pass.

Intestinal stoma constitutes a symptomatic treatment in a wide range of digestive diseases, such as rectal cancer, digestive traumatic perforation and inflammatory intestinal diseases. It affects a patient's life causing physiologic and social constraints. The stoma can lead to involution of the downstream digestive tissue, impairing his function in case of restored continuity. Some technical solutions have been developed in order to maintain intestinal continuity, reduce inflammatory risk and to increase patient's quality of life. In this paper, we describe a smart intestinal prosthesis equipped with a pump working as an intestinal segment and creating a bypass between the upstream and downstream intestinal sides. We also evaluate the performance the digestive prosthesis ECEP vs a simple digestive By-Pass.