Gallbladder torsion is a rare cause of acute abdominal pain and can be a diagnostic challenge for the general surgeon. We herein present a case of an 81-year-old man who presented with right-sided abdominal pain and signs of intra-abdominal infection. Transabdominal ultrasound, computed tomography (CT) and magnetic resonance cholangio-pancreatography (MRCP) scans could not identify with certainty the underlying cause of the symptoms and eventually the patient underwent a diagnostic laparoscopy, which revealed the presence of gallbladder torsion. Sequentially, a laparoscopic cholecystectomy was performed in a standard fashion and the patient had an uneventful post-operative recovery. Our case highlights the importance of diagnostic laparoscopy as a diagnostic and treatment tool in unclear cases of acute abdomen.
Guidelines for the learning period of sentinel lymph node biopsy in breast cancer do not address important details such as the false negative rate way of calculation and the number of patients with positive axilla that should be included among the cases of this period. The aim of this study was to identify refinement points which should be included in the guidelines..
Methods
A systematic review was conducted conforming to PRISMA guidelines. The MEDLINE and Cochrane databases were searched for all articles published prior to April 2019 matching all of the keywords ‘bariatric’, ‘paraplegia’ and ‘spinal cord’. Articles were assessed for relevance and full texts reviewed.
In addition, clinical records were reviewed for three patients who underwent bariatric surgery at a single UK private institution. Non‐identifiable demographic, clinical, operative and outcome data were obtained from electronic records.