Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera
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Pancreatic pseudocysts are rare in children. Traumatic injury accounts for 80% of the cases. We present the case of a pancreatic injury with pseudocyst formation in a child and discuss the initial management of pancreatic injury as well as the treatment of pseudocyst formation in children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Laparoscopic colectomy for colon cancer--a trial update.
A prospective randomized trial was designed to test the hypothesis that disease-free survival and overall survival are equivalent regardless of whether patients receive laparoscopic assisted colectomy (LAC) or open colectomy. Secondary and tertiary aims will test the safety of LAC and the impact of LAC on quality of life and costs, respectively. ⋯ Although this study is ongoing; preliminary results suggest that open and LAC provide for the same extent of resection. The quality of life portion of the study is now complete and data will soon be available.
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All manner of foreign bodies have been extracted from the bladder. Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. ⋯ We report a case of a bullet injury to the bladder, which finally presented as a gross hematuria after remaining asymptomatic for four years. We present here an alternative to suprapubic cystostomy with a large bladder foreign body treated via a combined transurethral unroofing followed by removal using a grasper passed through a suprapubic laparoscopic port.
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The intercostal nerve syndrome is caused by an impingement of the intercostals nerve at the level of the anterior rectus sheath. It may lead to acute or chronic abdominal pain, it should therefore be considered in the differential diagnosis of the acute or chronic abdomen. ⋯ In our retrospective study 14 patients with 15 entrapment syndromes are described. If, sometimes after a few diagnostic and therapeutic detours, the diagnosis is established, surgical intervention with resection of the altered nerve at it's exit of the anterior rectus sheath can usually abolish the pain with little side effects.
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The aim of this study is prospectively to evaluate the serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels in detection of acute appendicitis in patients with right iliac fossa pain. Data were collected in prospective manner on 102 consecutive patients with right iliac fossa pain. Laparotomy was performed for suspected acute appendicitis for 55 of the 102 patients, of whom 49 patients had appendicitis, 6 patients non-appendicitis (NA), and the other 47 patients had nonspecific abdominal pain (NSAP) and they did not undergo operation. ⋯ Although the mean IL-6 levels were significantly different only in PA group than the others groups (P < 0.05). The sensitivity and specificity of serum CRP measurements were calculated as 96% and 87%, respectively whereas these were 33% and 83% for IL-6 levels for the diagnosis of the acute appendicitis. As a result, measurement of the CRP levels and WBC have an additional diagnostic value on the diagnosis of the acute appendicitis but determination of IL-6 levels which added to the test combination of WBC and CRP, the sensitivity for the diagnosis of the acute appendicitis was not changed whereas the specificity was decreased to 66%.