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Spontaneous gall bladder perforation in infants is rare. We report a 3-month-old male infant who presented with progressive abdominal distension, low-grade fever, bilateral hydrocele and acholic stools. Ultrasonography showed free fluid in the peritoneal cavity, which was bile-stained on paracentesis. Surgical exploration revealed sterile biliary peritonitis and a gangrenous gall bladder. Partial cholecystectomy with external biliary drainage resulted in satisfactory recovery. 相似文献
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Starship Children's Hospital in Auckland, New Zealand, serves a population of 1.2 million people and is a tertiary institution
for pediatric trauma. This study is designed to review all cases of abdominal injury (blunt and penetrating) that resulted
in injury of a hollow abdominal viscus including the stomach, duodenum, small intestine, large intestine and urinary bladder.
The mechanism of injury; diagnosis and outcome were studied. This was done by retrospective chart review of patients admitted
from January 1995 to December 2001. Thirty two injuries were found in 29 children. The age ranged from 7 months to 15 years
with boys represented more commonly. Small bowel was the most frequently injured hollow viscus. Computerized Tomography (CT
scan) is an extremely useful tool for the diagnosis of HVI. 相似文献
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Marcio Covas Moschovas Seetharam Bhat Marco Sandri Travis Rogers Fikret Onol Elio Mazzone Shannon Roof Alexandre Mottrie Vipul Patel 《European urology》2021,79(3):393-404
BackgroundUse of the single-port da Vinci SP robotic platform for various urological procedures has been described by several groups. However, the comparative performance of the SP robot in relation to earlier models such as the da Vinci Xi is still unclear.ObjectiveTo compare intraoperative and short-term postoperative outcomes between the da Vinci Xi and SP robots for patients undergoing radical prostatectomy (RP) in a referral center.Design, setting, and participantsData were prospectively collected for patients undergoing RP from June 2019 to April 2020 in a single center. The da Vinci SP was used for 71 patients and the da Vinci Xi for 875 patients. After propensity score (PS) matching, two groups of 71 patients were selected for the comparative study.InterventionRP via a transperitoneal approach using the same technique steps and anatomy access with both robot consoles.Outcome measurements and statistical analysisA PS analysis was performed using the covariates age, body mass index, Charlson comorbidity index, Sexual Health Inventory for Men score, American Urological Association symptom score, prostate size, prostate-specific antigen levels, Gleason score, D’Amico risk group, and degree of nerve-sparing. Intraoperative performance and short-term functional (continence and potency) and oncological outcomes were compared between the groups.Results and limitationsMedian follow-up was 4.4 mo (interquartile range [IQR] 1.6–7.2) for the SP group and 3.2 mo (IQR 1.6–4.8) for the Xi group (p = 0.2). The median total operative time and median console time were both significantly higher in the SP group, with median differences of 14 min (95% confidence interval [CI] 9–19) and 5 min (95% CI 0–5), respectively. The proportion of patients with blood loss of >100 ml was significantly lower in the SP group (difference of 27%, 95% CI 12–42%). No intra- or postoperative complications were reported in either group. There were no significant differences in pain scores at 6, 12, and 18 h or in positive surgical margin rates between the groups. The SP group had a significantly higher percentage of extraprostatic extension than the Xi group (difference of 16%, 95% CI 4.6–27%). None of the patients experienced biochemical recurrence during follow-up. The difference in continence rates at 45 d between the SP and Xi groups was 11% (95% CI ?5.6% to 28%) and the difference in potency rates at 45 d was ?7.3% (95% CI ?21% to 6.2%). The short-term follow-up for comparison of functional and oncological outcomes is a limitation.ConclusionsDespite differences in trocar placement and technology between the two da Vinci consoles, the SP has satisfactory intraoperative performance compared to the Xi. SP surgery can be performed safely and effectively during the initial learning phase. However, longer-term follow-up is needed to provide further evidence on the impact of SP implementation on functional and oncological outcomes.Patient summaryWe compared intraoperative and short-term postoperative outcomes for patients who underwent radical prostatectomy using two different robots, the da Vinci Xi and the single-port da Vinci SP. We found that operative time was longer for the Single Port console. Studies with long-term follow-up are needed to compare the functional and oncological outcomes. 相似文献
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Zafer Tandogdu Justin Collins Greg Shaw Jennifer Rohn Bela Koves Ashwin Sachdeva Ahmed Ghazi Alexander Haese Alex Mottrie Anup Kumar Ananthakrishnan Sivaraman Ashutosh Tewari Benjamin Challacombe Bernardo Rocco Camilo Giedelman Christian Wagner Craig G. Rogers Declan G. Murphy Dmitry Pushkar Gabriel Ogaya-Pinies James Porter Kulthe Ramesh Seetharam Markus Graefen Marcelo A. Orvieto Marcio Covas Moschovas Oscar Schatloff Peter Wiklund Rafael Coelho Rair Valero Theo M. de Reijke Thomas Ahlering Travis Rogers Henk G. van der Poel Vipul Patel Walter Artibani Florian Wagenlehner Kris Maes Koon H. Rha Senthil Nathan Truls Erik Bjerklund Johansen Peter Hawkey John Kelly 《BJU international》2021,127(6):729-741
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Ranjeet S. Narlawar Jeshil R. Shah Vipul Parikh Tufail Patankar 《European radiology》2001,11(6):955-958
The persistent mullerian duct syndrome represents a rare form of male pseudohermaphroditism, secondary to mullerian inhibiting
factor (MIF) deficiency. We describe imaging findings in a 30-year-old male (46 XY karyotype) with bilateral cryptorchidism
and mullerian duct anomalies (presence of uterus and fallopian tubes). Grade-III teratoma with yolk sac tumour was detected
in one of the undescended testis, lying in the pelvic cavity. The other testis was in the inguinal canal. The rest of the
wolffian duct structures (e. g. prostate, seminal vesicles) were nearly normal. Very few reports of imaging findings of this
entity have been published thus far, probably because of the rarity of entity, incidental detection of most of the cases at
surgery and relatively asymptomatic clinical presentation.
Received: 6 March 2000 Revised: 3 August 2000 Accepted: 8 August 2000 相似文献
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Vipul Gurjar B. M. Halvadia R. P. Bharaney Vicky Ajwani S. M. Shah Samir Rai Mitesh Trivedi 《The Indian journal of surgery》2014,76(2):91-94
To study the results of two techniques, simple interrupted closure and continuous with intermittent Aberdeen knot technique for midline laparotomy fascial wound closure. A random selection of 200 midline laparotomy cases was done. In one group (group A) of 100 cases, midline fascial wound closure was done with continuous sutures with intermittent Aberdeen knot technique using Prolene No. 1 suture material. In the other group (group B) of 100 cases, closure was done with the technique of simple interrupted sutures with Prolene No.1 suture material. Comparison of both the techniques regarding preoperative status and postoperative complication such as incisional hernia, wound dehiscence, suture sinus formation, stitch granuloma, and chronic wound pain was done according to clinical examination and recorded in the pro forma prepared. In group A, postoperative complications were incisional hernia 3 %, wound dehiscence 4 %, and suture sinus formation 1 %. In group B, postoperative complication were incisional hernia 5 %, wound dehiscence 4 %, and suture sinus formation 1 %. All these complications were statistically insignificant, in both group comparisons. While the complication such as stitch granuloma 3 %, chronic wound pain 3 %, and wound infection 4 % in group A was significantly less than in group B where the complication of stitch granuloma was 12 %, chronic wound pain 13 %, and wound infection 13 % (P value 0.03, P value 0.018, and P value 0.048, respectively). Both the techniques, simple interrupted suture closure and continuous with intermittent Aberdeen knot closure for midline laparotomy fascial wounds, show a similar rate of postoperative complication such as incisional hernia, wound dehiscence, and suture sinus formation. But the continuous suturing with intermittent Aberdeen knot technique is a better option to prevent complications such as stitch granuloma, chronic wound pain, and wound infection, which are higher in the simple interrupted fascial wound closure technique. 相似文献
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