Acute bilateral adrenal hemorrhage secondary to rough truck ride.

Acute bilateral adrenal hemorrhage secondary to indirect trauma is rare. This condition may mimic an acute surgical abdomen. We present such a patient in whom the anatomic diagnosis was confirmed by serial computed tomographic (CT) scans, and adrenal insufficiency by biochemical tests. The response to steroid replacement therapy was remarkable. Although the patient had normal coagulation parameters at the time of presentation, subtle changes resulting from earlier anticoagulation may have been a contributing factor.

Femoral neuropathy secondary to anticoagulant therapy.

Two patients with femoral neuropathy resulting from compression by spontaneous hematoma of the iliopsoas muscle while on anticoagulant therapy, were definitively diagnosed preoperatively by CT scan. Early decompression of the femoral nerve, after correcting the coagulopathy, is recommended to assure optimal chances for relief of pain and recovery of neurological function.

Complications of laparoscopic inguinal hernia repair.

Laparoscopic herniorrhaphy has been gaining popularity along with other minimally invasive surgical techniques. With the sophistication of instruments, evaluation of techniques and longer follow-up of patients, the outcome of such repairs is changing. Many authors are reporting a variety of techniques, complications, and results compared to conventional surgery.

Jaundice secondary to spilled gallstone during laparoscopic cholecystectomy.

Advantages of.laparoscopiC cholecystectomy (LC) in terms of shorter hospital stay, less pain, and diminished disabilrty are well documented. Less well documented are the long-term comptications of this procedure. We report a patient who developed obstructive jaundice 8 months following LC from a spilled gallstone. In our review of the literature using MEDLINE from January 1990to June 1995,we did not find this complication reported.

Laparoscopic abdominal incisional hernioplasty: principles, technique and complications.

Repair of incisional herniae by direct approximation of the edges is associated with high incidence of recurrence. Tension free repair with prosthetic material was an advance in decreasing the incidence of recurrence. Repair with prosthetic material, to be successful, re qui res extensive dissection and its associated complications. Advances in laparoscopy along with the improvements in prosthetic materials has opened up opportunity for further decreasing the incidence of recurrence with minimal dissection.

Metastatic melanoma of gastrocolic ligament treated with minimally invasive approach.

A patient with metastatic melanoma of the gastrocolic ligament was rendered clinically tumor free using a minimally invasive procedure. The technique and the rationale for the procedure are reviewed.