Marco Venza

Retroperitoneal sepsis with mediastinal and subcutaneous emphysema complicating stapled transanal rectal resection (STARR).

The STARR procedure was introduced a few years ago for the treatment of obstructed defaecation syndrome secondary to internal rectal intussusception and rectocele. We present a case of severe retroperitoneal sepsis with mediastinal and subcutaneous emphysema complicating STARR, treated by transperineal pelvic drainage and a loop sigmoid colostomy.

Intragastric Balloon Followed by Biliopancreatic Diversion in a Liver Transplant Recipient: A Case Report

Liver transplantation is a life-saving procedure for end-stage liver disease. In liver transplant recipients, morbid obesity influences post-operative survival and graft function. In 1996, our patient underwent a successful liver transplantation because of a HCV-related liver failure (body mass index (BMI) 31). Follow-up showed a functional graft and the development of severe obesity up to a BMI of 61 in January 2006. In January 2007, he was submitted to intragastric balloon therapy for 6 months, reaching a BMI of 54. In September 2007, he underwent a biliopancreatic diversion. During follow-up to March 2008, he reached a BMI of 42 with ameliorations of comorbidities. In May 2008, during a hospital admission, he suddenly died of a heart attack. Post mortem study revealed a myocardial infarction. This is the first world case report for this approach. According to our opinion, patient’s death was not related to bariatric surgery.

449 Medical and Surgical Treatment of Chronic Anal Fissure: Prospective Longer-Term Results

In this video presentation we are presenting a patient with a submucosal mass at the gastroesophageal junction (GEJ). At time of laparoscopic surgery, the mass was adherent to the GEJ and extended into the distal left esophagus. Resection of the mass included a portion of the lower esophageal sphincter and distal left esophagus. This area was then reconstructed primarily over a 42 Fr tapered Bougie with running 3.0 and 2.0 Vicryl® suture in two layer fashion. The patient did well post-operatively and was discharged home on day six.