Thirty-six patients with intrabiliary rupture of hepatic echinococcal cysts were managed between 1974 and 1993. Clinical findings, skin tests, serologic tests, and imaging techniques were used to establish the diagnosis. Twenty-five (69.4%) patients had pain, 24 (66.6%) jaundice, 22 (61.1%) fever, 20 (55.5%) chills, 10 (27.7%) malaise, and 7 (19.4%) other symptoms as the major causes of admission. All patients underwent choledochotomy and T-tube drainage. Treatment directed to the cyst was cystectomy and capittonage, cystectomy and drainage, and partial hepatectomy in 22, 12, and 2 patients, respectively. Omentoplasty was added to the treatment in 10 patients. Seven (19.4%) patients had complications. The period of hospitalization for patients with and without complications was 34.6 +/- 18.1 and 15.1 +/- 2.7, days, respectively. This study indicates that better results are obtained in patients with cystic lesions of the liver by avoiding percutaneous puncture or biopsy, the early use of ultrasonography and computed tomography, evacuation of the cyst together with its germinative membrane and the involved biliary tract under adequate care to avoid spillage into the peritoneal cavity, treating the remaining cavity according to its location, size, and the presence of infection, and decreasing the pressure in the biliary tract by T-tube drainage.

House advancement flap anoplasty is a relatively simple procedure, combining the beneficial features of rectangular flaps and V-Y plasties. It can be used in nearly all types of anoderm deficiencies with a high rate of success and patient satisfaction.

This report describes our technique and initial experience with total intraabdominal laparoscopic left colectomy on 3 patients. Three consecutive patients, 2 females and 1 male, underwent laparoscopic left colectomy due to sigmoid volvulus and villous adenoma, respectively. The technique described herein helps to locate the intracolonic lesion, enables en bloc resection, shortens the operation time, and reduces the cost. Because the procedure is minimally invasive, patient recovery is remarkable compared with the conventional technique. All of the patients in this report were discharged on postoperative day 4 without any morbidity.

Giant invasive condyloma acuminatum, also known as Buschke-Löwenstein tumor, is a human papilloma virus (HPV) type 6 or 10-associated lesion which is rarely seen in the anorectum. These lesions despite their histologic benignity are clinically malignant with a propensity for recurrence and invasion. The aggressive character of this lesion and its likelihood of malignant transformation together with the associated significant mortality require early surgical excision with clear margins. Authors report on a patient with giant perianal condyloma acuminatum who was treated in a single session by total excision and fasciocutaneous VY advancement flap.