BACKGROUNDPerforation remains a surgical disease and management means emergency surgical intervention. Primary closure with omental buttress, Graham's live/dead omental patch repair, Jejunal serosal (Thal) patch repair and antrectomy with Billroth II reconstruction have been the traditionally followed procedures depending on the site/size of the perforation. This study reports a series of cases of perforated duodenal ulcer closed by Gastric seromuscular advancement flap. This article compares the advantages and disadvantages of either methods and details the indications and method of this alternative repair.

Complete transection of duodenum and partial transection of transverse colon following blunt injury abdomen and its clinical picture is often obscure and is extremely rare. High index of suspicion on the basis of mechanism of injury is important in early diagnosis. Early intervention in duodenal injuries have improved outcome and if it is more than 24 hours the mortality increased from 11 to 40%. The retroperitoneal location of the duodenum, its proximity to important abdominal structures and organs, its marginal blood supply, the biliary, pancreatic secretion drainage and diagnostic delay of its injuries cause therapeutic difficulties. All these factors create intraoperative dilemmas in the surgical management of duodenal injuries. The management of duodenal traumas remains controversial. We have discussed here a case of complete transection of duodenum and partial transection of transverse colon injury in blunt injury abdomen with the handle bar in a two wheeler accident. KEYWORDSDuodenal Injury, Blunt Injury Abdomen, Tension Free Primary Anastomosis.HOW TO CITE THIS ARTICLE: Subbiah P, Papu GS, Rajendran R, et al. Management of complete transection of duodenum and partial transection of transverse colon in blunt injury abdomen in a rural setup.

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A case of giant cell tumour replacing the entire sternum for which total Sternectomy with B/L sternoclavicular joint excision was carried out. This procedure has been done for the first time in the literature. The clinical data are summarized and the surgical technique has been described. After Sternectomy the area of resection was reconstructed with stainless steel plates and screws, prolene mesh and poly methyl methacrylate which assured stability of the chest wall. We discussed the method of reconstruction, technical details and outcome of the procedure in terms of complications and the return of the preoperative level of function. KEYWORDSSternectomy, Giant Cell Tumour of Sternum, Sternal Tumours. HOW TO CITE THIS ARTICLE:Soundararajan JCB, Subbiah P, Rajendran R, et al. Total sternectomy with bilateral sternoclavicular joint excision for giant cell tumour sternum.

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