Allred Mathiasen (cubancougar0)

Complications can be avoided by directly visualising the intraabdominal organs using laparoscopic gastrostomy or laparoscopic-assisted PEG. However, these methods require general anaesthesia. Thus, the presence of redundant colons should be determined in advance to assess the risk of sigmoid mesocolon perforation. We should also assess the patients' swallowing function and estimate whether it may recover with rehabilitation before deciding to place a PEG tube. CONCLUSION PEG tube should be considered after careful patient evaluation. If PEG is required, clinicians should recognise the patient-specific risks and consider other surgical procedures to avoid complications. INTRODUCTION Myositis ossificans of the deltoid muscle is extremely rare. We present a case with unique presentation and MRI findings. CASE REPORT A 21-year-old female presented with a 3-month history of a swelling in lateral aspect of the right arm. There was no history of trauma, injection, or surgery to the area. Lificiguat Examination showed a 3 × 3 cm firm mass in the deltoid muscle. MRI findings were suggestive of myxoma. Surgical excision was done and histopathology showed the classic features of myositis ossificans. There was no recurrence at the final follow-up 7 months later. DISCUSSION Myositis ossificans of the deltoid muscle is very rare with only 6 cases previously reported in the literature. Our case is unique in presentation because it is the first case reported with no history of trauma, Injection, sickness or surgery in the area. We also review the literature for MRI features of Myositis ossificans and show that our case has a unique pattern. CONCLUSION We report on a rare case of Myositis ossificans of the deltoid muscle and review of the literature for similar cases and MRI features of Myositis ossificans. We show that our case was unique both in presentation and MRI finding. INTRODUCTION Traumatic injury to the pancreas is rare and difficult to diagnose, requiring immediate operative management. It also has high mortality and morbidity rates. Postoperative pancreatic fistula is one of the complications that is considered a nightmare for digestive surgeons. The prevalence of POPF is estimated at 13%-41%, with 28% of mortality rate and the most common cause of death is retroperitoneal sepsis and hemorrhage. It requires complex treatment and a long duration of hospitalization of patients with a large cost burden. PRESENTATION OF CASE Here we report 2 cases of POPF after pancreatic injury in abdominal trauma. The patients underwent emergency laparotomy. In the hospital ward, the patients developed wound dehiscence and a clear viscous pancreatic juice came out from the wound with high output. The installation of wall VAC using wall suction with pressure adjustments according to the number of products per day was performed. The patients showed good outcomes, the pancreatic juice output decreased and diminished, and the wound also narrowed and closed. DISCUSSION VAC using wall suction is a device that applies the technique of NPWT and an emerging procedure used to treat patients with complex wounds. NPWT can reduce pooling of fluid, while reducing shear stress and tissue hypoxia at the wound edges, and stimulating the release of vascular endothelial growth factor in wound milieu. CONCLUSIONS Tapering pressure of VAC using wall suction for treatment of pancreatic fistula in post laparotomy pancreatic injury patients is a simple and easy procedure with good outcomes. Although the electrokinetic injection mode is applicable for direct introduction of ionic components from highly viscous samples, this is the first work which studies this special feature of capillary electrophoresis for this purpose. 9 metal cations were determined in honey utilizing direct injection, zone electrophoretic separation and indirect UV detection of the sample components. Reproducibility better than 4 RSD% was found for peak areas and the LOD values ranged between 0.045