270 Spontaneous Trans-anal Evisceration of Small bowel: A Case Report

Introduction Trans-anal evisceration of small bowel is a very rare surgical presentation. The first case ever reported was in 1827. The exact mechanism of how this develops remains poorly understood. Majority of the cases recorded there was a perforation in the anterior wall of the rectum. Case Report: A 70-year-old female patient with a history of multiple strokes, presented with multiple small bowel loops eviscerated through the anus. The bowel was covered with warm saline soaked packs and the patient was transferred to theater. Abdominal exploration through was done. The bowel was carefully reduced. There was a longitudinal defect on the anterior wall of the rectum at the recto-sigmoid junction. There was also a large mesenteric defect and thrombosed mesenteric vessels compromising blood supply to part of the bowel, so resection of 50 cm of ileum, jejunostomy and a mucous fistula were performed. Conclusions Several pre-existing pathologies, like diverticular disease or rectal prolapse can result in thinning out of the wall of the rectum. That combined with increased intra-abdominal pressure can explain trans-anal evisceration of the bowel. This condition is typically managed by surgical intervention. The operation will depend on the extent of viability, contamination, and patient’s general condition.

Closing a longitudinal defect on a caudal hollow vein by using the technique for connecting paravasal tissues with adventitia of parallel going artery

This article describes the use of the tech-nique for connection of paravasal tissues with adventitia of a parallel-going artery to close a longitudinal defect up to 2 millime-ters long in the caudal vena cava. The study was conducted on 6 male white rats. The goal of our work was to evaluate the effec-tiveness of haemostasis by using the method of connecting paravasal tissues of the caudal vena cava with adventitia of a parallel-running artery. All surgical interventions were performed under general anesthesia, in compliance with the rules of aseptics and antiseptics. A vessel defect was created by dissecting its paravasal tissue and the vein wall in the longitudinal direction with the tip of a 21G injection needle, then it was removed by connecting the paravasal tissue of the caudal vena cava and the aorta adventitia. For this, 2 sutures were applied by using Nylon USP 9-0 with a pricking atraumatic needle. The time taken to close the defect and the effec-tiveness of haemostasis were evaluated. As a result of the studies, we came to the follow-ing conclusions: the average time taken to close the defect was 3.3 ± 0.34 minutes. Un-like the classical method, we do not waste time isolating the vessel from surrounding tissues and the parallel artery, and also the suture is not placed through all layers of the vessel, causing a traumatic effect on the inti-ma. This technique is effective for haemo-stasis, in five out of six cases, the blood stopped 4 minutes after the closure of the defect on the vessel. And in one of six cases, blood stopped 6 minutes after the closure of the defect.

Crack identification using piezoelectric testing on carbon steel pipe for transverse, longitudinal and hole defects with low excitation frequency

AC excitation signal is most widely used in Non Destructed Testing (NDT) devices for Piezoelectric Technique (PZT) method in an inspec-tion. This paper is presenting the application of piezoelectric with end to end method for defect identification for Carbon Steel Pipe (CSP) where the frequency is used around 1kHz until 6kHz for standard pipe, transverse defect pipe, longitudinal defect pipe and hole defect pipe. From here, the identification of defect signal by based on the signal pick value and different pick signal between ordinary pipe (without defect) and defects pipe are analysis. The result shows that the standard pipe will give the high amplitude of signal compare the defect pipe by based on the type of defect, size of defect and depth of defect. Findings from the comparative study, validate the application of piezoelec-tric show that the different amplitude of the signal is directly proportional with excitation signal frequency and through the experiment, the longitudinal defect is contributed the different high signal until 79.7% compared to the hole and transverse defect 74.4 %.

New approaches to the treatment of anal fissure

According to Antropoli, pathologies of the anal canal are extremely common. About 30 to 40 percent of the population suffers from proctologic pathologies at least once in their lives. In most cases they are more annoying than dangerous. Anal fissure (AF) was recognized as a clinical entity in 1934 . It is a longitudinal defect of the anal canal mucosa and anoderm extending usually from the dentate line to the external verge of the anal canal. This defect exposes the lower half or even most of the fibres of internal anal sphincter. AF is almost always accompanied by extensive tension of this muscle. Anal fissures affect all age groups but predominantly occur in the 3rd and 4th decades of life (2,8,23). Gathright states that fissure disease causes from 6 to 15% of office visits and 10% of operative procedures in a colorectal practice. The etiology of anal fissure has only been partially explained and remains controversial although spasm of the internal anal sphincter has been recognized to play a main role in the pathogenesis of this disease. Recent studies have cast new light on the pathogenesis of anal fissures.

Osteocompatibility of Photopolymerizable Anhydride Networks

A new family of polyanhydrides has been developed which can be cured photochemically to produce degradable networks. These degradable polyanhydride networks can be useful in orthopedics as bone cements and for drug delivery. This system, which is a semi-interpenetrating network (semi-IPN), has been evaluated for tissue compatibility in subcutaneous sites in rats and shown to undergo degradation by surface erosion. It was observed that the inflammatory response to the semi-IPN implants was minimal at both short (3, 6 weeks) and long (28 weeks) time points and the fibrotic response was largely absent throughout the duration of this study. Furthermore, excellent tissue infiltration and integration with good neovascularization was observed around the semi-IPN implants. The osteocompatibility and osteoconductive properties of this system have been evaluated in a longitudinal defect model in the articular surface of the distal femur in adult rabbits. This study compared the semi-IPN implants to control groups consisting of unfilled defects and PLA implants. Histological evaluation (H&E and Trichrome Masson staining) of the implant site revealed that the semi-IPN implant is osteocompatible and well tolerated by the surrounding cancellous bone and marrow constituents. The tissue reaction to the implant is characterized by an ingrowth of vascularized connective tissue and a mild fibrous capsule. Furthermore, partial to complete closure of the articular surface with fibrocartilage and fibrous tissue was observed in all experimental animals containing the semi-IPN polymer implants.