Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Aug 2022
An Innovation in the Technique of Recipient Hepatectomy in Living Donor Liver Transplantation.
Recipient hepatectomy is a challenging surgical procedure. Coagulopathy, multiple collaterals, and dense adhesions secondary to previous spontaneous bacterial peritonitis in cirrhotics are the major contributing factors. However, the appropriate recipient hepatectomy technique can limit the massive blood loss and minimize the operative time. ⋯ In this report, a modified technique of recipient hepatectomy characterised by the artery-first approach is described. This technique is good in terms of preventing arterial dissection and minimising the anhepatic phase. Key Words: Recipient hepatectomy, Hepatoduodenal dissection, Liver transplantation, Technique.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsColonic Metastasis from Primary Tonsillar Squamous Cell Carcinoma: A Rare Cause of Large Bowel Obstruction.
Tonsillar squamous cell carcinoma is a subtype of head and neck cancer that rarely metastasizes to the colorectal system. Colonic metastasis secondary to primary tonsillar squamous cell carcinoma is a very rare clinical occurrence with unclear pathogenesis. ⋯ Here, we aimed to report a case of a 70-year male who underwent palliative surgery due to the symptoms of mechanical bowel obstruction as a result of colonic metastasis of tonsillar carcinoma and review the relevant literature. Key Words: Tonsillar carcinoma, Colon, Metastasis.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsGastric Lymphoma: Severe Gastric Outlet Obstruction Warranting Stent Placement.
Primary gastric lymphoma is an uncommon entity accounting for <5% of primary gastric neoplasms and 10-15% of all non-Hodgkin lymphomas. It may present with nonspecific symptoms or features of gastric outlet obstruction (GOO). GOO can develop prior to or during treatment due to disease or post-treatment scarring. ⋯ Gastroduodenal stenting with self-expanding metal stents (SEMS) has been used lately with excellent results but mainly in the palliative management of gastric carcinoma with GOO or in benign GOO. We present a case of gastric diffuse large B cell lymphoma on RCHOP chemotherapy who developed severe GOO leading to profound metabolic alkalosis and electrolyte imbalances, ultimately warranting an enteral stent. Key Words: Primary gastric lymphoma, Gastric outlet obstruction, Diffuse large B cell lymphoma, Enteral stent.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsInsidious Onset of Localised Small Intestinal Perforation by Ingested Plastic Fork.
Ingestion of a foreign body is generally observed in the psychiatric patients and children. Healthy adult individuals may also swallow a foreign body unintentionally. Here, we report a case of a patient who swallowed a plastic fork and treated with laparoscopic repair. ⋯ An accurate diagnosis of the small intestinal perforation caused by the ingested foreign bodies, particularly in cases where the patient is unaware of the ingestion, can be difficult. CT scan is a useful tool when available to establish the diagnosis before the surgical intervention. Key Words: Small intestine, Perforation, Foreign body, Laparoscopic surgery.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsAtypical Presentation of a Primary Thymic Adenocarcinoma.
Primary thymic adenocarcinomas are extremely rare and aggressive tumours. In this report, clinical and histopathological findings of this rare entity as well as its treatment approaches are presented. A 55-year man was operated for anterior mediastinal mass. ⋯ Complete surgical resection of the tumour is the most important factor. Adjuvant radiotherapy and/or chemotherapy as well as local therapies for metastases (surgical therapy or stereotactic radiosurgery) are seen as approaches to improve survival. Key Words: Adenocarcinoma, Metastasis, Stereotactic radiosurgery, Thymus.