Int Surg
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Review Case Reports
Spontaneous hematoma of the rectus abdominis sheath: a review of 177 cases with report of 7 personal cases.
Hematoma of the rectus abdominis muscle sheath is a little known and rarely diagnosed condition, in spite of its definite clinical setting and treatment. It is very important to the surgeon, as it may be mistaken frequently for acute inflammatory abdominal conditions and should be considered in the differential diagnosis of intra-abdominal tumors. The literature on 177 cases of non-traumatic hematomas of the rectus abdominis muscle sheath is reviewed, including seven personal cases reported by the authors. Its epidemiology, pathogenesis, clinical features, diagnostic examinations and treatment are discussed.
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Primary esophageal motility disorders include achalasia, diffuse and segmental esophageal spasm, nutcracker esophagus and hypertensive lower esophageal sphincter. Failed medical therapy frequently precedes the presentation of these patients for surgical intervention. Both laparoscopic and thoracoscopic techniques have been developed to successfully treat these spastic disorders of the esophagus. Laparoscopic and thoracoscopic operative techniques are described.
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Spontaneous pneumoperitoneum without peritonitis is a rare phenomenon which poses a dilemma to the surgeon faced with this problem. Two such cases and their outcome are presented. The first case was caused by barotrauma during positive pressure ventilation and was treated by laparotomy. ⋯ A compilation of other etiologies of pneumoperitoneum without peritonitis as extracted from the literature is presented. In the presence of pneumoperitoneum without peritonitis and when the clinical history does not suggest perforation of a viscus, we advise performing an abdominal tap. If negative, continued observation is advised.