MyMedR

Fulltext I jejunal patch repair of a duodenal perforation

Kalyani A, Teoh CM, Sukumar N

Med J Malaysia, 2005 Jun;60(2):237-8.

A patient with duodenal ulcer who developed iatrogenic perforation post endoscopy is presente. We present t is case that was treated successfully treated by jejunal serosal patch.

Matched MeSH terms: Laparotomy/methods*

Fulltext Hepatoblastoma in a low birth weight infant : a case report and review of the literature

Kaur G, Mutum SS

Malays J Med Sci, 2001 Jan;8(1):69-72.

PMID: 22973160

Hepatoblastoma is the most common primary liver tumour of childhood. This is a case report of a one-year-old boy who presented with a one-month history of progressive abdominal distension and weight loss. He was cachexic, anaemic, had gross hepatomegaly and ascites. He had been born prematurely with a birth weight of 1.23 kg, and his developmental milestones were delayed. Ultrasound and CT scan demonstrated a large solid tumour in the left lobe of the liver with a smaller superficial nodule in the right lobe. Serum alpha fetoprotein was significantly raised. A left lobe hepatectomy and complete excision of the right sided nodule was performed. There was no evidence of metastatic disease. Histopathological examination confirmed hepatoblastoma of the fetal type. The patient developed features of intestinal obstruction a few days after surgery and he succumbed ten days after re-laparotomy. The clinical presentation and investigation results in this case are characteristic. Recent reports have suggested a strong relationship between very low birth weight (< 1500gm)/prematurity and hepatoblastoma as is present in this case. Surgery is the mainstay of therapy in hepatoblastoma. A brief review of the literature on this tumour is presented.

Matched MeSH terms: Laparotomy

Fulltext Angiosarcoma of the liver

Khoo JJ

Med J Malaysia, 2002 Jun;57(2):233-6.

PMID: 24326660

A 47-years-old Malay man presented with unremitting epigastric pain and loss weight for 3 months. At laparotomy, a large tumour mas was found in the liver and a few small nodules in the spleen. Histopathological examination revealed a hepatic angiosarcoma with metastsis to the spleen. He had exposure to formic acid fumes for more than 23 years in his work as a rubber tapper. The various chemical carcinogens that are implicated in this type of tumour are discussed. The possiblity of an association between formic acid fumes and development of angiosarcoma in the liver is highlighted.

Matched MeSH terms: Laparotomy

Fulltext Mesocolic hernia: a rare cause of intestinal obstruction in childhood

Kihne M, Ramanujam TM, Sithasanan N

Med J Malaysia, 2006 Jun;61(2):251-3.

PMID: 16898325 MyJurnal

Mesocolic hernia is a rare cause of intestinal obstruction in children. The diagnosis involves a high index of suspicion and prompt intervention to prevent strangulation and a high morbidity. The embryological basis of the condition is of paramount importance to assist the eventual surgical correction.

Matched MeSH terms: Laparotomy

Rare case of huge retroperitoneal liposarcoma presenting as a gynaecological problem

Kuppuvelumani P, Rachagan SP, Syed N, Kumar G, Cheah PL

Eur J Obstet Gynecol Reprod Biol, 1993 Mar;48(3):220-2.

PMID: 8335141

A large retroperitoneal liposarcoma presented clinically as an ovarian tumour in an infertile woman. The importance of computed tomography in the differential diagnosis and the appropriate management of retroperitoneal liposarcoma is presented with a review of the relevant literature.

Matched MeSH terms: Laparotomy

A rare complication of endoscopic cystgastrostomy

Lee J, Sachithanandan S, Raman K

Gastroenterology, 2011 Nov;141(5):e1-2.

PMID: 21946349 DOI: 10.1053/j.gastro.2010.07.062

Matched MeSH terms: Laparotomy

Fulltext A puzzling case of biliary stricture with calcified liver nodules

Leow, V.M., Faizah, M.S., Yang, K.F., Hasnan, M.N., Manisekar, S.S.

International Medical Journal Malaysia, 2013;12(2):79-82.

MyJurnal

Tuberculous (TB) biliary stricture with calcified liver nodules rendering obstructive jaundice is a rare clinical phenomenon. Recently, we encountered a young patient with obstructive jaundice who was investigated in a general hospital. He was sent to our hospital for subsequent management after undergoing a series of investigations and biliary stenting. The radiological imagings performed revealed multiple calcified lesions in the liver with proximal bile duct strictures. Blood investigations, tumor markers and tuberculous work up were not remarkable. Subsequently, he underwent laparotomy and biliary reconstruction. Postoperatively, he was discharged well. Histopathological examination of the hepatoduodenal nodes showed chronic infections and granulomatous lymphadenitis, suspicious of a mycobacterium infection.

Matched MeSH terms: Laparotomy

Fulltext Case report: Ballotable abdominal mass in a child - Definitely renal in origin?

Lim GT, Teh YG, Ng CY, Mohd Khalid H, Hayati F

Ann Med Surg (Lond), 2021 Feb;62:84-87.

PMID: 33505677 DOI: 10.1016/j.amsu.2021.01.003

Introduction and importance: The differential diagnosis of a paediatric abdominal mass can be extensive, as it potentially involves multiple organs including gastrointestinal, genitourinary, endocrine, and gynaecological systems. Hence, a systematic approach to history taking and physical examination is needed to clinch the diagnosis. Specifically, the approach for assessing, investigating, and managing a ballotable left hypochondrial mass in a child can be challenging.

Case presentation: We report a 10-year-old Dusun girl presenting with left hypochondrial pain and noted a left hypochondrial mass on examination. This report highlights the role of clinical imaging during the pre-operative and post-operative phases.

Clinical discussion: Ultrasound and CT imaging was useful in determining that the tumor originated from the tail of the pancreas. The presence of a definite capsule with internal solid-cystic components helped narrowed the differential diagnosis to solid pseudopapillary neoplasm (SPN) of the pancreas. MR liver was useful to rule out liver metastasis in this child.

Intervention and outcome: The patient was scheduled for laparotomy and tumour excision at a regional paediatric centre. Successful excision of the tumor en-mass was performed and the child's subsequent recovery was uneventful.

Conclusion: Clinical imaging plays a critical role in the diagnosis and management of paediatric solid organ tumours. Other than renal origin, suspicion of pancreatic tail origin should be considered by clinicians when encountering a ballotable left abdominal mass.

Matched MeSH terms: Laparotomy

Fulltext Tubal Ectopic Pregnancy: Do Our Women Benefit From Laparoscopic Surgery?

Lim, K.J., Omar, M.H., Jamil, M.A., Ng, S.P.

International Medical Journal Malaysia, 2006;5(2):1-8.

MyJurnal

Introduction: Operative laparoscopy is the gold standard approach for treatment of tubal pregnancy. Although benefits of this approach are well established, data on its uptake trend in Malaysia is largely unknown. Objective: This study aims to determine the operative laparoscopy uptake in management of tubal pregnancy at a busy tertiary hospital and whether the benefits associated with laparoscopic surgery was achieved. Materials and Methods: This prospective observational study was conducted on all women admitted for tubal pregnancy at Hospital Sultanah Aminah, Johor Bahru, a public tertiary hospital over a period of 12 months. The on-call team was responsible for the surgical approach. Patient’s clinical presentation, operative laparoscopic uptake, factors affecting the choice of approach and duration of hospitalization were analyzed. Results: The tubal pregnancy rate was 7.6 per 1000 deliveries. Twenty- seven of the 138 cases (20%) had hypovolemic shock, requiring urgent laparotomy and were excluded from study. The operative laparoscopy rate for stable tubal pregnancy was only 42.3% (47 of 111 cases). Women managed laparoscopically were associated with a significantly higher pre-operative hemoglobin level, mostly nullipara and had surgery performed during office hours. They waited longer for their surgery but were discharged earlier compared to the laparotomy group. There was no difference in the duration of hospitalization. Conclusions: Less than half of all hemodynamically stable tubal pregnancies in our hospital had operative laparoscopy. The current laparoscopy uptake rate can be further improved.

Matched MeSH terms: Laparotomy

Fulltext Post partum vulvo-vaginal haematomas and options of management

Lim, P.S., Muhammad Abdul Jamil, M.Y, Zainul, R.A.Z, Mohd Hashim O., Rozman, Z., Shafiee, M.N., et al.

Journal of Surgical Academia, 2011;1(1):52-55.

MyJurnal

Vulvo-vaginal haematomas are not an uncommon obstetric complication. Despite advances in obstetric care, practice and technique, vulvo-vaginal haematomas do occur especially in complicated vaginal deliveries. Various management options are available for vulvo-vaginal haematomas. We describe three cases of vulvo-vaginal haematomas with different severity and presentations which were managed in different manners i.e. local haemostasis control, laparotomy with hysterectomy, and transarterial embolisation. The choice of treatment options would mainly depend on the clinical presentations, availability of expertise as well as facilities. Early identification is crucial.

Matched MeSH terms: Laparotomy

Fulltext Epidural buprenorphine and bupivacaine in major gynaecological operations

Loh SP

Med J Malaysia, 1993 Jun;48(2):207-10.

PMID: 8350797

Eight patients underwent major gynaecological operations. Their post-operative analgesia was provided by epidural buprenorphine 0.15 mg and bupivacaine 0.5%. The efficacy and side-effects of this combination were assessed. All patients had satisfactory analgesia ranging in duration from 10 hours to greater than 36 hours after a single dose injection. No significant side-effect was noted.

Matched MeSH terms: Laparotomy*

An evaluation of quality of life in women with endometriosis who underwent primary surgery: a 6-month follow up in Sabah Women & Children Hospital, Sabah, Malaysia

M F A, Narwani H, Shuhaila A

J Obstet Gynaecol, 2017 Oct;37(7):906-911.

PMID: 28617056 DOI: 10.1080/01443615.2017.1312302

Endometriosis is a complex disease primarily affecting women of reproductive age worldwide. The management goals are to improve the quality of life (QoL), alleviate the symptoms and prevent severe disease. This prospective cohort study was to assess the QoL in women with endometriosis that underwent primary surgery. A pre- and post-operative questionnaire via ED-5Q and general VAS score used for the evaluation for endometrial-like pain such as dysmenorrhoea and dyspareunia. A total of 280 patients underwent intervention; 224 laparoscopically and 56 via laparotomy mostly with stage II disease with ovarian endometriomas. Improvements in dysmenorrhoea pain scores from 5.7 to 4.15 and dyspareunia from 4.05 to 2.17 (p

Matched MeSH terms: Laparotomy/methods; Laparotomy/psychology

Fulltext Superselective mesenteric arterial branch cannulation for intraoperative identification of bleeding intestinal mucosal lesions

Mahadeven M, Samad SA, Leong KS

Med J Malaysia, 1994 Jun;49(2):192-4.

PMID: 8090105

The intraoperative localisation of small intestinal bleeding lesions identified at pre-operative angiography has always been difficult, resulting in extensive resections in doubtful cases. We report two patients in whom, at angiography, a small intestinal lesion was noted to be the cause of gastrointestinal haemorrhage. They then underwent superselective mesenteric arterial cannulation at a second angiographic procedure and were operated upon with the angiographic catheter left within the branch responsible for the bleeding. This superselective catheter placement facilitates precise localisation of the bleeding site intraoperatively, enabling limited segmental resection of bowel. Both patients have had no recurrent bleeding episodes.

Matched MeSH terms: Laparotomy

Fulltext Small bowel obstruction secondary to obturator hernia: A pre-operative diagnosis at computed tomography

Marlina Tanty Ramli Hamid, Mohd Shukry Mohd Khalid, Kartini Rahmat

Journal of Clinical and Health Sciences, 2021;6(1):46-49.

MyJurnal

Obturator hernia is rare, but it must be considered in elderly patients who present with small
bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as
the presenting symptoms and signs are usually non-specific. Presence of positive HowshipRomberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention
will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We
report a case of a 93-year-old female patient who was admitted to our surgical department with
symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative.
Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal
small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy
post-CT where the incarcerated bowel loop was released and the obstructed bowel was
decompressed without any complication. The hernial defect was close with a mesh and the
patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of
obturator hernia must always be considered in elderly patients who present with intestinal
obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids in appropriate
surgical intervention planning which is crucial in optimising the outcome.

Matched MeSH terms: Laparotomy

Rare complication of appendix: small bowel gangrene caused by the appendicular knot

Mohana RT, Zainal AA

Med J Malaysia, 2017 12;72(6):370-371.

PMID: 29308777 MyJurnal

Intestinal knot formation was first described by Riverius in 16th century and later by Rokitansky in 1836. We report a very rare cause of small bowel gangrene caused by appendiceal knotting on to the ileum in a previously healthy mid aged lady. Patient underwent laparatomy and right hemicolectomy and primary anastomosis. The intra operative findings were the appendix was twisting (knotting) the small bowel about 40cm from the terminal ileum and causing gangrene to the segment of small bowel. Appendicitis is a common condition and management is usually straightforward. However we must be aware of rare complications which may arise that require a change from the standard treatment of acute appendicitis.

Matched MeSH terms: Laparotomy

Fulltext Bleeding jejunal GIST: An uncommon cause of gastrointestinal bleeding

Mohanaraj T, Hanif H, Zainal AA

Med J Malaysia, 2015 Feb;70(1):31-2.

PMID: 26032526 MyJurnal

Gastrointestinal stromal tumours (GIST) are rare gastrointestinal tumours and are one of the causes of obscure gastrointestinal bleeding. We report a case of massive gastrointestinal bleeding secondary to bleeding jejunal GIST in a 43 years old gentleman. Endoscopic intervention failed to identify the source of bleeding and CT Angiography (CTA) showed a jejunal mass and patient underwent laparotomy and resection of the bleeding jejunal GIST. This article highlights the rare cause of the massive GI bleeding and also emphasise the role of CTA in obscure GI bleeding.

Matched MeSH terms: Laparotomy

Necrotizing enteritis

Mukherjee AP, Foong WC, Ferguson BR

Med J Malaya, 1971 Jun;25(4):285-7.

PMID: 4261302

Matched MeSH terms: Laparotomy

Fulltext Abdominal Mass in the Puerperium: Challenges in Diagnosis

Muniandy, Sadesvaran, Teo, Yvonne Chiang Hoon, Suleman, Aehtoosham, Ramaiah, Prakash Doddaballapur

Borneo Journal of Medical Sciences, 2019;13(3):37-42.

MyJurnal

Ovarian cancer is the fourth most common cancer among women in Peninsular Malaysia. Epithelial ovarian cancer accounts for 90% of all ovarian tumours. Herein, we present a rapidly growing ovarian tumour in a young female patient, following an uneventful vaginal delivery at home. We discuss on the challenges of making said diagnosis in a post-partum patient who presented with abdomen distension. A 19-yearold lady presented to the Emergency Department three days after spontaneous vaginal delivery at home. Her chief complaint was that of a rapidly progressive abdominal distension. Diagnostic and therapeutic emergency laparotomy were done, revealing a huge cystic ovarian mass. Histopathology reported a high grade, serous ovarian carcinoma. There are multiple causes for abdominal distension in post-partum women, however priority should be given into looking for gynaecological origin, given the changes in hormone. Sudden abdominal distension during post-partum period is rare and a systemic approach in its management is vital. There is, inarguably, a role of diagnostic and therapeutic laparotomy in this.

Matched MeSH terms: Laparotomy

Surgical ascites

Nadarajah C

Journal of the Malaya Branch of the British Medical Association, 1940;3:423-4.

Matched MeSH terms: Laparotomy

Laparoscopic localization and microlaparotomy for focal isolated perforation in necrotizing enterocolitis: an alternative approach to a challenging problem

Nah SA, Tan HL, Tamba RP, Aziz DA, Azzam N

J Pediatr Surg, 2011 Feb;46(2):424-7.

PMID: 21292104 DOI: 10.1016/j.jpedsurg.2010.11.045

Necrotizing enterocolitis has a wide clinical spectrum of manifestation. We report a novel method of managing focal isolated perforation in necrotizing enterocolitis by using diagnostic laparoscopy to localize the site of perforation and by making a microincision over the perforation to perform exteriorization or limited resection and primary anastomosis.

Matched MeSH terms: Laparotomy/methods*

Displaying publications 21 - 40 of 76 in total