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Sentinel lymph node biopsy (SLNB) is an established procedure for staging early breast cancer. Recently, methylene blue dye has been advocated as a safe, efficacious and cost-effective substitute for isosulfan blue in sentinel lymph node mapping. In this case report, we describe a 44-year-old woman who developed pulmonary edema associated with the use of methylene blue dye for SLNB.

Primary omental torsion is a rare cause of acute abdominal pain. A case of omental torsion in a 49-year-old woman who presented with clinical features consistent with acute appendicitis is discussed with a review of the literature.

Penetrating thoracic trauma may result occasionally in communication between the pleura and biliary tree. A case of traumatic pleurobiliary fistula secondary to stab wound of the right chest was demonstrated with (131)I-rose bengal scan. The diagnosis was made 15 days after trauma and was managed conservatively with a thoracostomy tube drainage.

Strangulated right Richter's inguinal hernia of the cecum is relatively rare. A case of this unusual hernia was successfully managed with a wedge resection and closure of the infarcted bowel wall in conjunction with complementary tube cecostomy. The procedure is easy to perform and relatively safe and is therefore recommended for use in selected cases of Richter's hernia of the cecum.

Chronic leg ulcers in sickle cell anemia occur mainly around the ankles. The prevalence is up to 75% in adults. These ulcers are painful and debilitating, yet medical treatment is unsuccessful. Surgical treatment consists of repeated skin grafting procedures, which eventually deplete the patient's available donor sites. Thus, in vitro generation of human epidermal autograft for potential treatment of leg ulcers in sickle cell anemia was initiated. However, because epidermal cells need a supporting matrix in order to be applied to the ulcer, the authors decided to assess the independent effect of a collagen matrix alone in promoting healing of sickle cell leg ulcers. Collistat (Hellistex, Inc) dressing was applied directly to the ulcers. The ulcers were reviewed every 2 weeks, and the dressing reapplied every 4 weeks. Collagen matrix caused the chronic ulcers to heal completely in fewer than 3 months. This encouraging performance of collagen alone should be greatly enhanced by the in vitro epidermal autograft.

Perforated bowel or diseases of the retroperitoneal organs may be complicated by retroperitoneal abscess formation. Six cases of retroperitoneal abscess treated at Ife University Teaching Hospital, Ile-Ife, Nigeria, over a two-year period are reported. Delayed presentation was responsible for the only death in the series and was also associated with prolonged morbidity in the remaining five cases. Early presentation and diagnosis, use of appropriate antibiotics, and prompt surgical intervention are factors that appear to influence the morbidity of the disease.