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Background/aims: The aim of this study was to retrospectively review all children who presented with intussusception over a 24-year period., Methodology: The medical records of children who presented with intussusception from July 1979 through July 2003 at Jordan University Hospital were reviewed., Results: One hundred and nine children (74 male, 35 female) presented with intussusception. Their mean age was 16.3 months (range 2 months-14 years). The presenting symptoms were: vomiting (92%), abdominal colic/pain (80%) rectal bleeding (78%), and abdominal mass (65%). Ninety-six cases were ileocolic intussusception (idiopathic type). Eleven patients had small bowel intussusception. Laparotomy was required in 86 cases, manual reduction being successful in 59 (56%); 20 (18%) had bowel resection; 2 had resection of Meckel's diverticulum; and 5 patients underwent Ladd procedure for associated malrotation., Conclusions: Idiopathic intussusception commonly presenting as an ileocolic type constituted the majority of the cases in the present study, occurring in 96 patients (89.7%). The clinical features were classical, vomiting being the most common. The average interval between the onset of symptoms and presentation to the hospital was 46 hours and barium enema reduction was successful in 20 out of 48 cases in which it was attempted. Surgical intervention was required in 86 cases (81%); of which manual reduction was successful in 59 cases, resection was required in 22 cases and 5 patients required an additional Ladd procedure for associated malrotation.

Background/aims: Management of common bile duct stones in the era of laparoscopic surgery is still controversial. The purpose of this study is to investigate the safety, feasibility, success rate and short-term results of the selective use of endoscopic retrograde cholangiopancreatography in patients undergoing laparoscopic cholecystectomy., Methodology: A prospective study comprising 300 consecutive patients with either symptomatic or complicated gallbladder stones was performed between January 1994 and November 1996. Depending on clinical, laboratory and ultrasonographic criteria, 73 patients (24.3%) underwent endoscopic retrograde cholangiopancreatography with or without endoscopic sphincterotomy. The procedure was successful in 71 patients (97%) either preoperatively in 62 patients (21%) or postoperatively in 9 patients (3%)., Results: Endoscopic retrograde cholangiopancreatography was positive in 37 cases (52%), endoscopic sphincterotomy and stone extraction was performed in 35 cases and endoscopic sphincterotomy alone was performed in 2 cases for benign papillary stenosis. The overall predictive value for the presence of common bile duct stone was 52%, the predictive value for patients with jaundice, dilated common bile duct together with elevated liver enzymes was 73.3%. Complications of perioperative endoscopic retrograde cholangiopancreatography were encountered in 4 patients (5.5%) with no mortality., Conclusions: We conclude that the combination of perioperative endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy is a useful approach for the management of choledochocholelithiasis.

Background/aims: Safety of laparoscopic cholecystectomy (LC) during pregnancy is still controversial, we report our experience in the management of 42 pregnant patients suffering from symptomatic gallbladder stones., Methodology: Between June 1993 and July 1998, we performed 1700 LC's. During this period we dealt with 42 pregnant patients who had symptoms of gallbladder stones. Following an initial period of conservative management, only 16 patients underwent LC during pregnancy and 26 patients responded to medical management and were operated upon later on after delivery., Results: Sixteen patients were operated upon successfully during pregnancy, 2 in the 1st trimester, 10 in the 2nd trimester and 4 in the 3rd trimester. No complications occurred and all patients carried on their pregnancies to term and delivered healthy babies., Conclusions: From our experience and from the review of the literature on this subject, LC during pregnancy is safe, however the indications should be restricted to patients with complications or to those suffering from repeated and persistent symptoms not responding to medical management.