Retrieval of a retained video capsule endoscope with laparoscopic surgery.

Capsule endoscopy (CE) is commonly used for examining and diagnosing gastrointestinal disease, especially small bowel disease. Capsule retention is a well-known and significant complication of CE and requires surgical or endoscopic removal. Most reports described the retrieval of retained CE via laparotomy. We report a case of successful retrieval of the capsule using laparoscopic surgery.

Pharmacobezoar-a rare case presented as gastric outlet obstruction.

BEZOARS are retained concretions of indigestible foreign material that accumulate and conglomerate in the gastrointestinal tract, most commonly in the stomach. Prevalence of bezoar is 0.4%. Bezoars are classified in four categories: phytobezoars; trichobezoars; pharmacobezoars; lactobezoars. A 58-year-old man admitted with complains of pain abdomen and recurrent vomiting since last 3 months. Upper GI endoscopic biopsy reported-chronic gastritis with very occasional non-caseating epitheloid granuloma in lamina propria, no evidence of neoplasia? Crohn's disease. Keeping Crohn's as diagnosis patient was given mesalamine 400 mg tid by gastrophyscian. But patient did not respond so the patient was advised surgical management. Repeat UGI endoscopy revealed multiple pills (mesalamine) in the stomach with gastric outlet obstruction (GOO). Around 40 pills were extracted with the help of flower basket, and then patient develope GOO and underwent Laparoscopic gastrojejunostomy and truncal vagotomy.

Validation of Boey's score in predicting morbidity and mortality in peptic perforation peritonitis in Northwestern India.

BACKGROUND: The major complications of peptic ulcer are hemorrhage, perforation and gastric outlet obstruction with perforation occurring in about 2-10% of patients. Patients with perforated peptic ulcer still have a high rate of morbidity and mortality and to improve the outcomes it is important to stratify the patients into different categories. AIMS: To evaluate the accuracy of Boey scoring system in predicting postoperative morbidity and mortality in patients operated for peptic perforation. METHODS: It was a prospective observational single centre study conducted at SMS Medical College and Hospital, Jaipur, from October 2011 to October 2012 on 180 patients undergoing open surgery for peptic ulcer perforation. Postoperative outcomes in terms of recovery and complications were studied. For prediction of morbidity and mortality by Boey risk stratification, the odds ratio (OR) and 95% confidence interval (95% CI) of each risk score were compared with the outcomes of "0" risk score. RESULTS: The mortality rate increased progressively with increasing numbers of the Boey score: 1.9%, 7.1%, 31.7% and 40% for 0, 1, 2, and 3 scores, respectively (p < 0.001). The morbidity rates for 0, 1, 2, and 3 Boey scores were 13%, 45.7%, 70.7% and 73.3% respectively (p < 0.001). CONCLUSIONS: Boey score is a useful tool for assessing the prognosis of operated cases of peptic perforation and helps in the assessment of mortality and morbidity of these patients.

Gastric glomus tumor.

Glomus tumors (GTs) are benign tumors originating from the glomus body which are usually solitary and small lesions. The vast majority are found in the distal extremities, particularly in the hand, wrist, foot and under the fingernails rarely involving visceral organs. Here we report a rare case of gastric GT presented to us with exsanguinating hematemesis and severe anemia. All the initial diagnostic tests were inconclusive. Contrast-enhanced computed tomography abdomen revealed a soft tissue density lesion within the first part of duodenum. Diagnostic laparotomy was planned and a mass of 3 × 2.5 × 2 cm was found at pylorus along greater curvature, without any evidence of lymphadenopathy or metastasis. Distal gastrectomy with gastrojejunostomy was done. Histopathology confirmed the diagnosis of a GT. Immunohistochemistry of tumor cells demonstrated smooth muscle actin and CD34 (very focal).