Twelve goats were inoculated with 40,000 third-stage Haemonchus contortus larvae and two were killed on each of Days 4, 7, 11, 14, 18 and 21 after inoculation (DAI). The number of worms that established, and the site of development were recorded. More worms established in the fundic, than in the middle or pyloric thirds of the abomasum. Early development occurred within the mucosa; emergence into the lumen started between 7 and 11 days after infection. By 4 DAI, all worms had completed the third moult to the L4 stage. At 11 DAI the majority of the worms were adults. A mean of 13.2% of the female worms had eggs in their uteri at 18 DAI; by 21 DAI more than half of the female worms had eggs in their uteri. The development of H. contortus was essentially similar to that described in sheep.
There is an increasing trend in the number of bariatric surgeries performed worldwide, partly because bariatric surgery is the most effective treatment for morbid obesity. Sleeve gastrectomy (SG) remains the most common bariatric surgery procedure performed, representing more than 50% of all primary bariatric interventions. Major surgical complications of SG include staple-line bleeding, leaking, and stenosis. A leak along the staple-line most commonly occurs at the gastroesophageal junction (GOJ). From January 2018 to December 2018, our centre performed 226 bariatric procedures, of which, 97.8% were primary bariatric procedures. The mean age and BMI were 38.7±8.3 years and 44 kg/m2, respectively. Out of the 202 primary SG performed, we encountered two cases of a staple-line leak (0.99%). This is the first reported case series of SG leaks from the Southeast Asia region. A summary of their characteristics, clinical presentation, subsequent management, and the outcome is discussed. Based on the latest available evidence from the literature, several methods may decrease staple-line leaks in SG. These include the use of a bougie size greater than 40 Fr, routine use of methylene blue test during surgery, beginning transection at 2-6 cm from the pylorus, mobilising the fundus before transection, and staying away from the GOJ at the last firing. Other methods include the proper alignment of the staple-line, control of staple-line bleeding, and performing staple-line reinforcement. The management of a staple-line leak remains challenging due to limited systematic, evidence-based literature being available. Therefore, a tailored approach is needed to manage this complication.