Int Surg
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Cronkhite-Canada syndrome (CCS) is a very rare disease which may cause malignant transformation. A combination regimen including corticosteroids are common therapy for CCS, however the decrease of medicine may lead to CCS relapse and also may contribute to malignant transformation of the polyps in gastrointestinal tract. ⋯ We believe close follow-up should be taken when CCS patients are making medicine dosage alteration and tumor marker such as CEA may be included in the surveillance examination. When improvement using conservative treatment can be neither obtained nor is expected, the use of surgery should be considered.
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Review Case Reports
What we know about management of traumatic abdominal wall hernia: review of the literature and case report.
Traumatic abdominal wall hernia (TAWH) is an uncommon form of hernia caused by blunt traumatic disruption of the abdominal wall musculature/fascia and abdominal organ herniation. Diagnosis of TAWH is challenging and requires a high level of suspicion. This form of hernia seems to be underrepresented in the English-language medical literature. ⋯ In this article, we discuss the management of a 36-year-old motorcycle driver who was involved in a road traffic accident. On evaluation at our trauma center, he was found to have TAWH. Diagnostic criteria, imaging modalities and different management options for TAWH will be discussed.
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Randomized Controlled Trial
Value of extended warming in patients undergoing elective surgery.
Perioperative temperature management is imperative for positive surgical outcomes. This study assessed the clinical and wellbeing benefits of extending normothermia by using a portable warming gown. A total of 94 patients undergoing elective surgery were enrolled. ⋯ A nonsignificant 48% relative decrease in hypothermic events was observed for the extended warming group (P = 0.12). Patients receiving the warming gown were more likely to report always having their temperature controlled (P = 0.04) and significantly less likely to request additional blankets for comfort (P = 0.006). Clinical outcomes and satisfaction were improved for patients with extended warming.
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Rectus sheath hematoma (RSH) is a rarely-occurring disease that is usually associated with anticoagulation, trauma, or spontaneous events. Most spontaneous rectus sheath hematomas may be relieved with conservative management. ⋯ Respecting the fact that the inferior epigastric artery mainly supplies the rectus abdominis muscle, interrupting its proximal side would cease the bleeding. We present a stepped procedure of ligation of the inferior epigastric artery and evacuation of hematoma with good field of vision in case of rectus sheath hematoma in hemodialysis patient.
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Randomized Controlled Trial
One, two, or three ports in laparoscopic cholecystectomy?
Single-port laparoscopic cholecystectomy (LC) has been compared with 3- or 4-port LC. To our knowledge, there are no studies comparing the 3-, 2-, and 1-port techniques. Patients were randomized into 3 groups: LC 1-port using SILS, LC 2-port using a laparoscope with a working channel, and LC 3-port using the standard ports. ⋯ At recovery, there was less pain in group 1 (P = 0.002); at 4 hours pain was similar in all groups (P = 0.899); at 24 hours there was less pain in groups 2 and 3 (P = 0.031); and at days 5 and 8 there was marginal (P = 0.053) and significant (P = 0.003) relevance. In terms of pain perception, LC performed through 1 port does not offer advantages when compared with 2 or 3 ports. More clinical trials are needed to confirm these data.