Local application of 5-FU significantly reduced peritendinous adhesion. Local IFN-α and IFN-β had no significant effect on the prevention of peritendinous adhesion formation. The strength of the repair was not affected by these cytokines and 5-FU.

Trocar insertion is an essential and initial part in any laparoscopic procedure. Inadvertent abdominal wall vascular injury, leading to intra-abdominal bleeding or abdominal wall haematoma due to trocar insertion, may occur at this first step. We report here a case of uneventful laparoscopic cholecystectomy in a 44-year-old woman, which was followed later by large abdominal wall haematoma through the 5 mm trocar insertion site. Emergency laparotomy was needed to control the bleeding. Delayed abdominal wall haematoma can occur even with most lateral, 5 mm trocar insertions. Learning abdominal wall vascular anatomy, transilluminating the abdominal wall before trocar insertion and entering the abdominal cavity at a right angle may decrease the possibility of this complication.

Intramural hematoma of the colon should be considered as a diagnosis in anticoagulated patients who present with prolonged INR and GI symptoms. In stable cases, conservative medical treatment can be sufficient to avoid unnecessary procedures.

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Background: Peritendinous adhesion is the most common complication following tendon surgery, particularly in zone 2 of the hand. Prevention of inflammation around tendon that develops following trauma and surgery can decrease tendon adhesion formation. This study evaluates the effect of some anti-inflammatory cytokines and 5-fleurouracil in prevention of peritendinous adhesion formation. Methods: Sixteen rabbits were allocated equally into 4 groups. Tendons of index and ring fingers in zone 2 of the right hind paw were cut in all animals and then repaired. In groups 1 and 2, interferon (IFN)-α and 5-fluorouracil (5-FU) were administered locally to repair sites of index and ring fingers, respectively. In groups 3 and 4, normal saline and IFN-β were locally applied to repair sites of index and ring fingers, respectively. Three weeks later, tensiometric and histopathologic evaluations were performed. Results: The force required for removing the tendon from the sheath was not different between the groups ( P, .130), but the time that was required for removal was significantly shorter in 5-FU group ( P, .049). The strength of repair was not different between the groups in terms of force and time needed for rupture ( P, .11 and .67, respectively). In histopathologic examination, normal architecture of tendon and peritendon environment was less disturbed in IFN groups, especially in IFN-β specimens. Conclusions: Local application of 5-FU significantly reduced peritendinous adhesion. Local IFN-α and β had no significant effect on prevention of peritendinous adhesion formation. Strength of the repair was not affected by these cytokines and 5-FU.