Biomedical subjects
Publications and source records attributed to W K Cheah.
A patient swallowed a fish bone that perforated the stomach wall and embedded in the head of the pancreas. This was confirmed by computed tomographic imaging. We describe a case of successful fish bone removal using a laparoscopic technique, thus avoiding a laparotomy. The patient recovered well and was discharged from the hospital the next day. This is the first description of such a case.
Needlescopic surgery is a refinement of laparoscopic surgery wherein instruments smaller than 3 mm are used. The advantage is the minute wounds that heal imperceptibly. Initial reports of needlescopic cholecystectomy were confined to uninflamed gallbladders where the antegrade technique was invariably used. This case demonstrates a needlescopic cholecystectomy by the retrograde approach for an inflamed gallbladder.
A retrospective review was performed of the records of 93 children with urinary tract calculi treated during a 10-year period (1983 to 1992). Two distinct groups of patients were identified. One group comprised 63 Aboriginal children, mainly from the northern region of Western Australia, who presented at a young age (average, 2.8 years) with urinary tract infections and failure to thrive. The other group comprised of 30 non-Aboriginal children, mainly from the metropolitan region, who presented at an older age (average, 6.7 years) with abdominal and flank pain. Calculi were located in the upper urinary tract in 85 children (91.4%) and in the bladder in eight (8.6%). Most patients underwent open surgical procedures for removal of their calculi, and the overall success rate was 86%. In recent years, percutaneous nephrolithotomy has been used successfully in selected patients with renal pelvic calculi. This method seems to be the trend for the future.
BACKGROUND/AIMS: Benign duodenal tumors are rare and less common than malignant tumors. They comprise a wide variety of pathologies. Treatment is by endoscopic excision or surgical resection. In this report, we aim to review the management of benign tumors located in the proximal duodenum. METHODOLOGY: A retrospective review of 11 patients with benign duodenal tumors treated in a single institution was performed over 10 years. Malignant tumors and periampullary tumors were excluded from the study. RESULTS: The most common presentations were abdominal pain and upper gastrointestinal bleeding. Diagnosis was established by gastroduodenoscopy with biopsy. Seven tumors were located in the first part of the duodenum. The mean size of the tumors was 2.8 cm. Three patients with bleeding tumors were treated with endoscopic hemostasis and underwent surgery because the tumors were larger than 2 cm. Four patients had endoscopic polypectomies and 5 patients had surgical excision. The histological types included 6 adenomas, 3 Brunner's gland adenomas or harmatoma, 1 schwannoma and 1 leiomyoma. The results were good with only 1 case of recurrence. CONCLUSIONS: The presentation of benign duodenal tumors is non-specific. They are diagnosed by gastroduodenoscopy and the tumors can be removed if small and pedunculated. Endoscopic ultrasound is useful in detecting submucosal involvement of sessile tumors. In such cases and large tumors (> 2 cm), surgical excision by laparotomy or laparoscopy should be undertaken.