Journal of Gastrointestinal and Hepatic Surgery

Review Article Pages 67-76

Liver Trauma: Review of Management, and Patient Outcomes at Our Major Trauma Centre

Authors: Laing RW, Edwards M, Faulkner T and Roberts KJ

Abstract: The liver is the largest solid organ in the body, has two blood supplies and performs around 500 functions. It has an unrivalled capacity to regenerate in response to injury - a feature described in Greek mythology and one that has evolved in response to damage from the very toxins it is meant to clear. Its complexity however, can also be its downfall. It is one of the only organs whose functions cannot be artificially replicated and for this reason liver failure is often a fatal event. In spite of residing under the right costal margin, it is the most frequently injured organ during abdominal trauma.

|

Case Report Pages 63-66

Management of Refractory Post-Pancreaticoduodenectomy Chyle Leak by Lymphangiographic Embolization of the Cisterna Chyli

Authors: Hitali Majetia, MS, Mayur Porwal, MS, Imran Khan, MS, Vivek Shetty, DNB, Shaji Marar, MD , Soumil Vyas, MS, DNB, FRCS and Nilesh Doctor, MS, DNB, FRCS

Abstract: Post-pancreatectomy chylous ascites (CA) is a well-known but poorly characterized complication. Literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Diagnosis of CA is established on the characteristic milky turbid appearance of the fluid which is rich in Triglycerides. Chylous leak can lead to significant morbidity including malnutrition and increased risk of sepsis. A good number of cases respond to initial conservative measures which include dietary adjustment including Medium Chain Triglycerides and high protein diet, somatostatin analogues and total parenteral nutrition.

Original Article Pages 56-62

Closed Loop Obstruction Following Roux-En-Y Anastamosis: Mechanisms and Prevention

Authors: Govind K Purushothaman MBBS, MS, Mehul Vikani MBBS, MS, Mayuresh Jaiswal MBBS, MS, Soumil Vyas MS, FRCS and Nilesh Doctor MS, FRCS

Abstract: Intestinal obstruction following Roux en Y anastomosis is usually a closed loop obstruction and should be treated as a surgical emergency. A low index of suspicion should prompt urgent Computerised Tomographic (CT) scan of the abdomen, which is diagnostic.. A retrospective study of 6 patients who underwent reoperation after Roux en Y anastamosis done for a variety of indications was undertaken..