American journal of surgery
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The authors present a case of a huge right inguinal bulge that was referred as a right inguinal hernia. At surgery, it was confirmed to be a giant lipoma of the spermatic cord. A description of the case, pictures of clinical appearance and operative specimen, and a short literature review are presented.
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In honor of the seminal contributions of Dr. Shukri Khuri to the foundation and development of the National Surgical Quality Improvement Program (NSQIP), a review of recent work and new directions within the American College of Surgeons (ACS) NSQIP is presented, according to the following outline:
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An esophageal perforation occurred during an esophagogastroduodenoscopy (EGD). The patient had an episode of retching and forceful vomiting just after an esophageal mucosal biopsy at the gastroesophageal junction. The only clinical feature demonstrated by the patient was neck crepitation after completion of the EGD. ⋯ A unique chest computed tomography scan demonstrated suspension of the esophageal mucosal surface and lumen in a "bull's eye" configuration. A water-soluble esophageal swallow followed by a thin liquid barium swallow demonstrated that the esophageal perforation had sealed. The patient completely recovered with conservative medical therapy of clear liquid diet and antibiotics.
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Pancreatic stone is a rare disease, and it may be associated with obstructive jaundice. We recorded clinical data and accurate images of the pancreatic stone. Whipple operation was performed to relieve the obstructive jaundice. The pancreatic stone is an uncommon entity with obstructive jaundice and may require surgical management if endoscopy or extracorporeal shock wave lithotripsy failed.
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Exsanguination from hepatic trauma is exacerbated by the lethal triad of acidosis, coagulopathy, and hypothermia. We evaluated the application of a modified chitosan dressing in a hypothermic coagulopathic model of grade V liver injury. ⋯ Modified chitosan dressings provide simple rapid treatment of life-threatening liver injuries.