The CSS more often matched the opinion of experienced senior surgeons compared to CCI. The modified CSS significantly correlated with other patient-centered outcomes.

A 55-year-old woman presented with features of gastric outlet obstruction not responding to conservative treatment at a peripheral hospital. She had gastric surgery 15 years before. On examination, there was a globular mass palpable in the epigastrium. Ultrasound and endoscopy findings were suggestive of retrograde jejunogastric intussusception. After initial resuscitation, emergency laparotomy was undertaken which revealed a jejunogastric intussusception at the previous retrocolic gastrojejunostomy site. After manual reduction of the intussuscepted loop by gentle traction, another segment of the jejunum was seen to be telescoping within this loop. On reduction, this jejunal loop was seen to measure around 20 cm and the apex of the intussusceptum was found to be gangrenous and perforated. Resection of the involved segment was done followed by a Roux-en-y anastomosis to restore the continuity.

No abstract

Background: This study aimed to evaluate the safety and efficacy of USG-guided percutaneous drainage in liver abscesses of >5 cm. A lot of literature is available on the minimally invasive treatment of liver abscesses since its introduction in the early 1980s. This study focuses on the eastern Indian population and the outcome of treatment of liver abscess of >5 cm by means of catheter drainage and the use of antibiotics. Patients and Methods: This is a retrospective study conducted on a total of fifty patients over a period of 1 year, 1 month (from June 2017 to June 2018). Only patients with liver abscess with size >5 cm were included in the study. The demographic characteristics; comorbidities; and clinical, radiological, and bacteriological characteristics of liver abscesses in the eastern Indian population and the safety and efficacy of catheter drainage were evaluated. Results: It was found that because of preprocedural empirical antibiotic intake, 70% of the patients had no growth in the pus, whereas 12% had Entamoeba histolytica , 8% had Escherichia coli , and 6% had Klebsiella pneumoniae as the causative agent. The total duration of hospital stay ranged from 3 to 22 days, and the duration of intravenous antibiotics ranged from 1 to 9 days with a clinical success rate of 96% without any drainage-related complications. Conclusion: In contradiction to the earlier belief, percutaneous drainage is a safe and effective means of treatment in liver abscesses of >5 cm with high clinical success rate and reduced duration of intravenous antibiotic requirement as well as hospital stay.

The mean observation period was longer for the LCJ group than for the OCJ group (31.6 vs. 25.3 months, p = 0.03). The incidence of postoperative cholangitis tended to be higher (16.9% vs. 8.2%, p = 0.061) and the incidence of intrahepatic stone was significantly higher in the LCJ group (8.4% vs. 1.9%, p = 0.035). The proportion of patients who required invasive intervention for anastomotic stenosis, such as endoscopic or percutaneous stenting or surgical reanastomosis, was significantly higher in the LCJ group (11.7% vs. 1.9%, p = 0.005). Conclusions: Although LCJ using continuous suture had been standardized within the study period, it is more likely to cause anastomotic stenosis than OCJ using interrupted suture.