We read the interesting paper Staged Laparoscopic Roux-en-Y: A Novel Two-Stage Bariatric Operation as an Alternative in the Super-obese with Massively Enlarged Liver, by the renowned Ninh T. Nguyen, with M. Longoria, D.V. Gelfand, A. Sabio, and S.E. Wilson.1 The enlarged liver is a major concern for the bariatric surgeon. The effort to create alternatives to operate on patients with this proble...

We treated a 23-year-old aboriginal woman with drug-resistant pulmonary tuberculosis (TB). She experienced intolerance to her oral anti-TB medications, had subtherapeutic drug levels, and failed to respond to treatment. She then was effectively treated with percutaneous gastrojejunostomy tube (PGJT) administration of drugs. We present our data on the serum drug levels of rifampin, para-aminosal...

10-40% of Roux-en-Y gastric bypass (RYGB) patients regain significant weight after Roux-en-Y gastric bypass surgery due to dilation of the pouch and/or the gastrojejunal (GJ) anastomosis. Traditional revision surgery is associated with significant morbidity (e.g. post-anastomotic GJ leak) where less invasive endoluminal procedures may represent safer alternatives. The present article reports a ...

Two cases with intractable vomiting due to gastroparesis, a rare feature of diabetic autonomic neuropathy, are described. Both required surgical treatment. In the first a gastroenterostomy was complicated by reflux gastritis requiring a revision operation; in the second a gastrojejunostomy was successful. Electron microscopic studies of the vagus nerve in one of the cases showed a severe reduct...

Sir,?A male patient, aged about 35 years, a Kapu by caste, came to the London Mission Hospital, Kamalapuram, in July 1924, suffering from abdominal pain with discomfort and vomiting, of 6 or 7 years' duration. On examination of the case a diagnosis of pyloric stenosis was made and a date fixed for operation. As the equipment at this branch hospital was inadequate for the operation, a message wa...