Tubular Duplication of the Sigmoid Colon with Acute Abdomen: An Adult Case Report.

Colonic duplication is a rare abnormality, comprising only 6-7 % of all gastrointestinal duplications and usually present during the first decade of life. Tubular duplications of the sigmoid colon are extremely rare and only a few cases have been reported in the literature. In this study, we report the case of a 27-year-old rural man visited our hospital with symptom of repeated episodes of abdominal pain in epigastric region that radiated to right flank and back. An abdominal computed tomography (CT) scan with oral and intravenous contrast revealed an extremely dilated and air-filled loop related to sigmoid colon. An exploratory laparotomy was performed and tubular sigmoid colon duplication was found intraoperatively. The postoperative period was uneventful.

Successful prevention of tunneled, central catheter infection by antibiotic lock therapy using cefotaxime.

BACKGROUND: Chronic hemodialysis patients frequently require vascular access through central venous catheters (CVCs). The most significant complication of these catheters is infection. This risk can be lowered by the use of an antibiotic-Heparin lock. This study focuses on hemodialysis patients using Tunneled-cuffed catheters (TCC), to assess the rate of catheter-related infections (CRI) in catheter-restricted filling with Cefotaxime and Heparin in end stage renal disease patients. METHODS: A double-blind randomized study was conducted to compare 5000 U/ml Heparin plus10 mg/ml cefotaxime (CE/HS) as catheter-lock solutions, with Heparin (5000 U/ml) alone. A total of 30 patients with end-stage renal disease and different etiologies, were enrolled for chronic hemodialysis with permanent catheters from December 2009 to March 2010. These patients were randomly assigned to two groups of 15 members. Blood samples were collected for culture, sensitivity, and colony count, from the catheter lumen and the peripheral vein. CRI was considered as the end point. RESULTS: The rate of CRI was significantly lower in the cefotaxime group versus control group (p < 0.001). No exit site infection was occurred in both groups. Infection-free survival rates at 180 days were 100% for the CE/HS group, and 56% for the HS group. CONCLUSIONS: Antibiotic lock therapy using cefotaxime reduces the risk of CRI in hemodialysis patients.

Metastatic hernial sac tumor in a patient with FUO.

The presence of primary or metastatic cancer within a hernia sac is uncommon, which occurs in fewer than 0.5% of all surgically excised sacs (1). This article demonstrates a case of a metastatic pancreatic cancer, one of which presented as an inguinal hernia with fever of unknown origin (FUO). A 44-year-old male presented with a history of FUO and a painful inguinal hernia. Inguinal canal exploration revealed a mass like lesion in the sac without any correlation to abdominopelvic viscera. Postoperative evaluations confirmed moderately differentiated metastatic adenocarcinoma from pancreatic origin.

Effect of melatonin in the prevention of postoperative pericardial adhesion formation.

To evaluate the efficacy of melatonin in preventing postoperative pericardial adhesions, 12 single breed dogs were randomized equally into experimental (melatonin) and control groups. After ketamine anesthesia, a vertical midsternal incision was done and the parietal pericardium of the inferior site of the heart was opened vertically. To promote adhesion formation, abrasions were created on both parietal and visceral pericardial surfaces in an area of 2 cm2 with two vertically reciprocal movements of dry gauze. In the melatonin group, 5% ethanol plus 10 mg/kg melatonin in 10 ml NaCl and, in control group, 10 ml NaCl dilution vehicle containing 5% ethanol was instilled intra-pericardium on to the abrasion sites. After a 6-week recovery period, the animals were evaluated for grading of adhesion formation by an examiner blinded to the groups. The extent of adhesions was graded from 0 (no adhesion) to 3 (total involvement of the traumatized area). The results showed that adhesion scores were significantly lower in melatonin group (1.00+/-0.63) compared with controls (2.66+/-0.51); P=0.001. We conclude that melatonin administration effectively reduced postoperative pericardial adhesions in dogs. The use of melatonin in the prevention of pericardial adhesion formation in human subjects warrants further investigations.