scholarly journals Our experience in gastrointestinal perforations: a retrospective study

2017 ◽  
Vol 4 (2) ◽  
pp. 593
Author(s):  
Thammegowda Kemparaj ◽  
Narasimhamurthy Kadirehalli Narasimhaiah ◽  
Ravikiran Keragodu Mayigaiah
Keyword(s):  
Retrospective Study ◽  
Single Unit ◽  
Enteric Fever ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Surgical Emergencies ◽  
Perforative Peritonitis ◽  
Case Files ◽  
Duodenal Perforations ◽  
Surgical Unit

Background: Peritonitis secondary to gastrointestinal perforation is still one of the commonest surgical emergencies in India and is associated with high morbidity and mortality. The present study examines the incidence of various types of gastrointestinal perforations, their complications and the management of patients with postoperative leaks in our surgical unit and compares our findings with those of previous studies performed between 1984 and 2014.Methods: Retrospective study analyzing the case files of all the operated cases of gastrointestinal perforations in a single unit over the last 10 years from September 2005 to August 2015 by open procedure. A total number of 381 cases were studied. All cases with perforative peritonitis, whether spontaneous, infective, traumatic or of neoplastic pathology, were included in the study.Results: Gastrointestinal perforations were common between the ages of 30-50 years; 82% were males. From July to October (rainy seasons) every year a higher number of perforations were noticed; 40% of patients had duodenal, 34% had ileal, 11% appendicular, 6% gastric, 6% jejunal and 3% had colonic perforations. Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (50%) and tachypnea (42%) were common signs; 15-20% presented late with features of shock.Conclusions: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever (typhoid) have highest morbidity and mortality. Most of the anastomotic leaks can be treated conservatively. Mortality depends on the general condition of the patient and associated pre-operative comorbidities.

scholarly journals Aetiological Pattern of Gastrointestinal Perforations: A Prospective Observational Study

2021 ◽  
Vol 29 (2) ◽  
pp. 106-109
Author(s):  
Prosunto Kumar Das ◽  
Chowdhury Md Mushfiqur Rahman ◽  
AZM Mahfuzur Rahman ◽  
Md Nayeem Dewan ◽  
Md Mahmudul Islam ◽  
...  
Keyword(s):  
Enteric Fever ◽  
Early Recognition ◽  
College Hospital ◽  
Female Ratio ◽  
Ulcer Disease ◽  
Medical College ◽  
Surgical Emergencies ◽  
Perforative Peritonitis ◽  
Perforation Peritonitis ◽  
Duodenal Perforations

Introduction: Peritonitis secondary to gastrointestinal perforation is one of the commonest surgical emergencies encountered all over the world. This study was done to highlight the spectrum of perforation peritonitis encountered in surgery unit of Dhaka Medical College Hospital. Method: It was observational prospective of 100 cases of perforation peritonitis treated in our hospital. All cases of perforative peritonitis whether spontaneous, infective or neoplastic pathology were included in this study. Results: The maximum numbers of patients were in age group between 31 to 40 years (39 %) with mean age 35 years. Male female ratio was 9:1. The most common aetiology of perforation peritonitis was peptic ulcer disease (73%) followed by enteric fever (12%), appendicitis (10%), tuberculosis (3%) and malignancy (2%). The most common sites of perforation were in descending order of frequency - first part of the duodenum (65%), terminal ileum (12%), appendix (10%), gastric antrum (9%), jejunum (3%) and rectum (1%). Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (96%), muscle guard and rigidity (100%) were the common signs. Approximately 15-20% presented late with features of shock. Mortality rate was 2% and was significantly high in patients coming hospital late. Conclusion: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever have highest morbidity. Early recognition and timely appropriate intervention is very important in reducing morbidity and mortality. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 106-109

scholarly journals TRENDS OF POISONING AMONG CHILDREN AT KASTURBA HOSPITAL, MANIPAL

2013 ◽  
Vol 03 (02) ◽  
pp. 025-028
Author(s):  
Pratik Vijay Tarvadi ◽  
Shankar M. Bakkannavar ◽  
Manjunath S. ◽  
Vikram Palimar ◽  
G. Pradeep Kumar ◽  
...  
Keyword(s):  
Developing Countries ◽  
Retrospective Study ◽  
Forensic Medicine ◽  
Morbidity And Mortality ◽  
Medical Emergency ◽  
High Morbidity ◽  
Kasturba Medical College ◽  
Infants And Toddlers ◽  
Medical College ◽  
Childhood Poisoning

Abstract Background: Pediatric poisoning is a common medical emergency and also associated with a high morbidity and mortality in children. In developing countries like India, poisoning emergencies are becoming a major cause of mortality in infants and toddlers. Among the various studies conducted on poisoning in our country, the study on poisoning is predominantly on adults and hence this study is taken up to understand the incidence of childhood poisoning cases. Method: A ten year retrospective study from January 1999 to December 2008 was conducted at the Department of Forensic Medicine & Toxicology, Kasturba Medical College, Manipal, to comprehend the magnitude of childhood poisoning cases at Kasturba Hospital, Manipal. Results: Insecticide poisoning was the most predominant poisoning followed by venomous bites. Conclusion: Our study examines the most common poison involved and route of intake among children to identify specific ages at risk and give suggestions so as to reduce the morbidity and mortality.

scholarly journals A retrospective study on the seasonal occurrence of Japanese Encephalitis cases in Uttar Pradesh

2021 ◽  
Vol 8 (4) ◽  
pp. 1762
Author(s):  
Jaideep K. Chaubey ◽  
Vinod K. Srivastava ◽  
Virendra Kumar ◽  
Arslan Neyaz
Keyword(s):  
Retrospective Study ◽  
Japanese Encephalitis ◽  
Communicable Disease ◽  
Monsoon Season ◽  
Uttar Pradesh ◽  
Public Health Problem ◽  
Morbidity And Mortality ◽  
Seasonal Occurrence ◽  
High Morbidity ◽  
Major Public Health Problem

Background: Japanese encephalitis (JE) is a dreaded mosquito-borne viral disease, especially in Asian, Western Pacific, and Northern Australia region and a major public health problem in India. In India, State of Uttar Pradesh contributed a large portion of JE cases to the country. Because of its high morbidity and mortality, JE is of particular interest. With the help of specific intervention, we can prevent the morbidity and mortality of JE cases. The objective of the study was to know the seasonal occurrence of JE cases in Uttar Pradesh.Methods: This was a retrospective study based on secondary data, shared by Communicable Disease wing of Swasthya Bhawan, Lucknow, Uttar Pradesh (U.P) for the analysis. We used data for the study during the past 7 years (2010–2016). Analysis has been done using Microsoft Excel.Results: In Uttar Pradesh, there were 1322 cases of JE during the year 2010-2016. Peak incidence of JE cases were seen in months of September. An overall decreasing trend with some fluctuation was seen in the occurrence of cases from 2010 to 2016. It was also observed that maximum cases were occurred in monsoon season. Majority of the cases were seen in Gorakhpur district which is located in eastern part of Uttar Pradesh.Conclusions: Majority of the cases of JE were seen in rainy months. Gorakhpur district of Uttar Pradesh has the highest load of JE cases. IEC activities should be carried out to disseminate the information regarding JE among the people for prevention.

Management of oesophageal anastomosis dehiscence after oesophagectomy for oesophageal cancer

2020 ◽  
Vol 99 (5) ◽  
pp. 200-206
Keyword(s):  
Oesophageal Cancer ◽  
Surgical Procedure ◽  
Anastomotic Dehiscence ◽  
Gastric Conduit ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Therapeutic Algorithm

Oesophagectomy is being used in treatment of several oesophageal diseases, most commonly in treatment of oesophageal cancer. It is a major surgical procedure that may result in various complications. One of the most severe complications is anastomotic dehiscence between the gastric conduit and the oesophageal remnant. Anastomotic dehiscence after esophagectomy is directly linked to high morbidity and mortality. We propose a therapeutic algorithm of this complication based on published literature and our experience by retrospective evaluationof 164 patients who underwent oesophagectomy for oesophageal cancer. Anastomotic dehiscence was present in 29 cases.

Open and laparoscopic surgeries are associated with comparable 90 day morbidities and mortalities following ERAS protocols- A retrospective Study. (Preprint)

2020 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel
Keyword(s):  
Multivariate Analysis ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Operative Time ◽  
Univariate Analysis ◽  
Morbidity And Mortality ◽  
Morbidity Rate ◽  
Blood Products ◽  
Asa Score

UNSTRUCTURED All the gastrointestinal surgeries performed between April 2016 to march 2019 in our institution have been analysed for morbidity and mortality after ERAS protocols and data was collected prospectively. We performed 245 gastrointestinal and hepato-biliary surgeries between April 2016 to march 2019. Mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. Mean ASA score was 2.40, mean operative time was 111 minutes, mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall 90 days mortality rate was 8.5% and over all morbidity rate was around 9.79% . On univariate analysis morbidity was associated significantly with higher CDC grade of surgeries, higher ASA grade, more operative time, more blood products use, more hospitalstay, open surgeries,HPB surgeries and luminal surgeries(non hpb gastrointestinal surgeries) were associated with higher 90 days morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90 days mortality was predicted by grade of surgeries, higher ASA grade, more operative time, more blood products use, open surgeries and emergency surgeries. However on multivariate analysis only more blood products used was independently associated with mortality There is no difference between 90 day mortality and moribidity rates between open and laparoscopic surgeries.

scholarly journals Pneumocephalus Following Self-Inflicted Penetrating Brain Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Che-Fang Ho ◽  
Yuan-Yun Tam ◽  
Chia-Chen Wu
Keyword(s):  
Rare Complication ◽  
Bed Rest ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Adequate Treatment ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Intravenous Antibiotics ◽  
Computed Tomography Scans ◽  
Intravenous Hydration ◽  
Prompt Diagnosis

Objective. Pneumocephalus is a rare complication that often occurs after traumatic skull base injury, leading to morbidity and mortality. Material and Method. We present the case of a 42-year-old healthy man who injured himself when he stuck a metal stick into his left nasal cavity to relieve prolonged nasal obstruction. Immediate cerebrospinal fluid rhinorrhea and subsequent meningitis and pneumocephalus occurred later. He was presented at our hospital with fever and meningeal signs. Result. Computed tomography scans revealed left rhinosinusitis and air collection in the subarachnoid space. The patient received the conservative treatment of bed rest, intravenous hydration, head elevation, and broad-spectrum intravenous antibiotics. Pneumocephalus and meningitis resolved without any surgery, and he experienced no other sequela or complication. Conclusion. Pneumocephalus is a rare incidence and can lead to high morbidity and mortality. Prompt diagnosis and adequate treatment of pneumocephalus and meningitis proved beneficial for our patient who recovered without any complication or surgery.

scholarly journals Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation

2013 ◽  
Vol 53 (1) ◽  
pp. 6
Author(s):  
Indah Nurhayati ◽  
Muhammad Supriatna ◽  
Kamilah Budhi Raharjani ◽  
Eddy Sudijanto
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Study ◽  
Pleural Effusion ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Patient Outcomes ◽  
Morbidity And Mortality ◽  
Chi Square ◽  
X Ray ◽  
Chest X Ray

Background Most infants and children admitted to the pediatricintensive care unit (PICU) have respiratory distress and pulmonarydisease as underlying conditions. Mechanical ventilation may beused to limit morbidity and mortality in children with respiratoryfailure.Objective To assess a correlation between chest x-ray findingsand outcomes of patients with mechanical ventilation.Methods This retrospective study was held in Dr. KariadiHospital, Semarang, Indonesia. Data was collected from themedical records of children admitted to the PICU from Januaryto December 2010, who suffered from respiratory distress andused mechanical ventilation. We compared chest x-ray findings tothe outcomes of patients. Radiological expertise was provided byradiologists on duty at the time. Chi-square and logistic regressiontests were used for statistical analysis.Results There were 63 subjects in our study, consisting of 28 malesand 35 females. Patient outcomes were defined as survived or died,43 subjects ( 68%) and 20 subjects (3 2%), respectively. Chest x-rayfindings revealed the following conditions: bronchopneumonia48% (P=0.298; 95%CI 0.22 to 1.88), pleural effusion 43%(P=0.280; 95%CI 0.539 to 4.837) , pulmonary edema 6%(P=0.622; 95%CI 0.14 to 14.62) and atelectasis 3% (P=0.538;95%CI 0.03 to 7 .62). None of the chest x-ray findings significantlycorrelated to patient outcomes.Conclusion Chest x-ray findings do not correlate to patientoutcomes in pediatric subjects with mechanical ventilation inthe PICU of Dr. Kariadi Hospital, Semarang, Indonesia.

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