scholarly journals A comprehensive study on acute non-traumatic abdominal emergencies

2017 ◽  
Vol 4 (7) ◽  
pp. 2297
Author(s):  
Ajay Malviya ◽  
Ashfaque Hussain ◽  
Hitesh P. Bulchandani ◽  
Girish Bhardwaj ◽  
Subhash Kataria
Keyword(s):  
Acute Appendicitis ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Operative Management ◽  
Hollow Viscus ◽  
Correct Treatment ◽  
Medical College ◽  
Abdominal Emergencies ◽  
Hollow Viscus Perforation ◽  
Overall Mortality

Background: Abdominal pain is one of the most common reasons for visit to the emergency room. Acute appendicitis is the commonest cause. An accurate diagnosis is essential for the correct treatment, which in many cases will prevent the death of the patient. Mainstay of diagnosis is history and physical examination. If this information is inadequate to establish a diagnosis and urgent or immediate operation is unnecessary, the periodic re-examination helps document the progression of the disease and often avoids unnecessary surgical intervention. Today the combination of improved diagnostic procedures, antibiotic and better anaesthesia and preoperative and postoperative patient care has led to a decrease in morbidity and mortality of patients with acute abdomen. The objective of this study was to determine the various causes of non-traumatic acute abdominal emergencies, their incidence, management and mortality in both sexes and all age groups >12 years age.Methods: The Study was conducted on 1353 patients of non-traumatic abdominal emergencies admitted in the department of surgery, associated group of hospitals attached to Dr. Sampurnanand Medical College, Jodhpur over a period of 1 year extending from 1st January 2015 to 31st December 2015.Results: Most common cause of acute non-traumatic emergency in our study is acute appendicitis 61.71% of the patients. Out of 1353 cases of non-traumatic acute abdominal emergencies, 217 (16%) were managed conservatively while 1136 (84%) were operated. 96.64% cases of acute appendicitis were operated and only 3.36% underwent conservative management. The rate of operative intervention in acute intestinal obstruction and acute cholecystitis was 89.09% and 85.71% respectively. 81.89% cases of hollow viscus perforation were operated while 18.11% were treated conservatively. Only 18.18% cases of liver abscess underwent operation while all patients of Meckel's Diverculititis were managed operatively. All patients of acute pancreatitis were managed conservatively. Overall mortality in our study of acute non-traumatic abdominal emergencies was 3.39%.Conclusions: It can be concluded that acute non-abdominal emergencies admitted in the hospital constitute a major chunk of surgical patients, majority requiring operative management with limited mortality.

A COMPREHENSIVE STUDY ON ACUTE NON-TRAUMATIC ABDOMINAL EMERGENCIES

2021 ◽  
pp. 14-16
Author(s):  
Md. Quamar Zubair ◽  
A. K. Jha Suman
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Surgical Intervention ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Accurate Diagnosis ◽  
Postoperative Patient ◽  
Correct Treatment ◽  
Abdominal Emergencies ◽  
Comprehensive Study

Abdominal pain is one of the most common reasons for visit to the emergency room. Acute appendicitis is the commonest cause. An accurate diagnosis is essential for the correct treatment, which in many cases will prevent the death of the patient. Mainstay of diagnosis is history and physical examination. If this information is inadequate to establish a diagnosis and urgent or immediate operation is unnecessary, the periodic re-examination helps document the progression of the disease and often avoids unnecessary surgical intervention. Today the combination of improved diagnostic procedures, antibiotic and better anaesthesia and preoperative and postoperative patient care has led to a decrease in morbidity and mortality of patients with acute abdomen. The objective of this study was to determine the various causes of nontraumatic acute abdominal emergencies, their incidence, management and mortality in both sexes and all age groups >12 years age.

scholarly journals Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.
Keyword(s):  
Perioperative Complications ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Threatening Condition ◽  
Hollow Viscus Perforation

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.

scholarly journals EFFECTIVENESS OF MANNHEIM PERITONITIS INDEX IN PREDICTING THE MORBIDITY AND MORTALITY OF PATIENTS WITH PERITONITIS FOLLOWING HOLLOW VISCUS PERFORATION

2020 ◽  
pp. 48-50
Author(s):  
Pradipta Pandit ◽  
Tanmoy Bhuyan ◽  
Rahul Kushwaha
Keyword(s):  
Surgical Treatment ◽  
Antimicrobial Agents ◽  
Risk Groups ◽  
Morbidity And Mortality ◽  
Related Factors ◽  
Hollow Viscus ◽  
Mannheim Peritonitis Index ◽  
Medical College ◽  
Specific Factors ◽  
Hollow Viscus Perforation

Background: One of the common cause of emergency surgery in India is peritonitis due to hollow viscous perforation. The morbidity and mortality of secondary peritonitis remains high despite advances in surgical skills, antimicrobial agents and supportive care. Many factors determine the prognosis and outcome which includes patient related factors, disease specific factors and management of the case. Management of these case are done by categorizing patients into different risk groups. Based on measuring simple clinical parameters in case of hollow viscous perforation Mannheim peritonitis index (MPI) is calculated. To know efficacy of MPI for predicting morbidity and mortality in hollow viscous perforation this study was conducted. Methods: 50 patients who were undergoing surgical treatment for peritonitis following hollow viscous perforation at Silchar Medical College and Hospital, Silchar were included in study. Clinical data, surgical treatment, outcome were documented and analysed. Results: In patients with MPI more than 29 the morbidity and mortality rate were higher. The most common complication in patients with MPI less than 21 was surgical site infection while of those with MPI more than 21 the respiratory complications were common. The ICU stay of the patients were increased if the MPI Score was higher. Conclusions: MPI is simple and effective in predicting morbidity and mortality in patients with hollow viscous perforation and is very easy to calculate.

scholarly journals Appendicular Mass: A Conservative Approach

2016 ◽  
Vol 5 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Ashok Koirala ◽  
Dipendra Thakur ◽  
Sunit Agrawal ◽  
Kamal Raj Pathak ◽  
Manoj Bhattarai ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Age Groups ◽  
Age Group ◽  
Conservative Approach ◽  
Medical College ◽  
Number Of Patients ◽  
Interval Appendicectomy ◽  
To Come ◽  
Age Range ◽  
Appendicular Mass

Introduction Appendicular mass is one of the most common complications following acute appendicitis and seen in 2-6% of the patients. The treatment of appendicular mass is controversial with three general approaches. The aim of this study is to evaluate outcome of conservative approach.Material & Methods A retrospective analysis of the patients managed with appendicular mass from 1st January to 31st December 2014 was carried out in NMCTH, Biratnagar. A total of 173 patients with diagnosis of appendicular mass admitted in emergency and OPD of our hospital were studied. All age groups and both sex were included.Results Out of 496 patients with appendicitis, 173 patients [34.87%] were diagnosed with appendicular mass. Age range of the patient in the study varied between 4-84 years and maximum patients found in the age group of 21-30 years. Onset of symptoms was between 2-6 days and greater number of patients reporting between 5-6 days. During study period 10(5.7%) patients came with recurrence, 9 [5.2%] developed abscess, 35(20.23%) patients came for interval appendicectomy, whereas 119 [68.78%] failed to come for a follow up.Conclusion Our study concluded that the appendicular mass can be managed successfully by conservative approach, although few complications may arise which can be managed by surgical intervention.Journal of Nobel Medical College Vol.5(2) 2016; 47-50

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

scholarly journals Appendiceal adenocarcinoma found by surgery for acute appendicitis is associated with older age

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
John P. Skendelas ◽  
Victor S. Alemany ◽  
Vincent Au ◽  
Devika Rao ◽  
John McNelis ◽  
...  
Keyword(s):  
New York ◽  
Acute Appendicitis ◽  
Incidental Finding ◽  
Population Sample ◽  
Operative Therapy ◽  
Operative Management ◽  
The United States ◽  
Improvement Program ◽  
Common Procedure ◽  
Appendiceal Neoplasms

Abstract Background Appendectomy for acute appendicitis is the most common procedure performed emergently by general surgeons in the United States. The current management of acute appendicitis is increasingly controversial as non-operative management gains favor. Although rare, appendiceal neoplasms are often found as an incidental finding in the setting of appendectomy. Criteria and screening for appendiceal neoplasms are not standardized among surgical societies. Methods The National Surgical Quality Improvement Program (NSQIP) database was queried for all patients who underwent appendectomy over a 9-year period (2010–2018). Over the same time period, patients who underwent appendectomy in two municipal hospitals in The Bronx, New York City, USA were reviewed. Results We found a 1.7% incidence of appendiceal neoplasms locally and a 0.53% incidence of appendiceal tumors in a national population sample. Both groups demonstrated an increased incidence of appendiceal carcinoma by age. This finding was most pronounced after the age of 40 in both local and national populations. In our study, the incidence of appendiceal tumors increased with each decade interval up to the age of 80 and peaked at 2.1% in patients between 70 and 79 years. Conclusions Appendiceal adenocarcinomas were identified in patients with acute appendicitis that seem to be associated with increasing age. The presence of an appendiceal malignancy should be considered in the management of older patients with acute appendicitis before a decision to embark on non-operative therapy.

Anesthetic management of a patient with hollow viscus perforation due to blunt abdominal trauma with grade IV hemorrhagic shock

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Reza Widianto Sudjud ◽  
Djoni Kusumah Pohan ◽  
Muhammad Budi Kurniawan ◽  
Hana Nur Ramila
Keyword(s):  
Hemorrhagic Shock ◽  
Blunt Abdominal Trauma ◽  
Massive Transfusion ◽  
Damage Control ◽  
Anesthetic Management ◽  
Hollow Viscus ◽  
Permissive Hypotension ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol ◽  
Hollow Viscus Perforation

Hemorrhagic shock is a form of hypovolemic shock in which severe blood loss leads to inadequate oxygen delivery at the cellular level. Death from hemorrhage represents a substantial global problem, with more than 60,000 deaths per year in the United States and an estimated 1.9 million deaths per year worldwide, 1.5 million of which result from physical trauma. This case report aims to stress the need of handling cases of hemorrhagic shock in accordance with damage control protocol. Hemorrhagic shock management using permissive hypotension management, bleeding control, massive transfusion protocol (MTP), minimal crystalloid therapy, and adjuvant therapy is the best approach to get optimal outcome to prevent triad of death. In this case, the application of damage control resuscitation has not been fully implemented because of several constraints. Key words: Hemorrhage; Hemorrhagic shock; Permissive hypotension; Massive Transfusion Protocol; MTP; Resuscitation; Damage control Citation: Pohan DK, Sudjud RW, Kurniawan MB, Ramila HN. Anesthetic management on patient with hollow viscus perforation due to blunt abdominal trauma with grade IV hemorrhagic shock. Anaesth. pain intensive care 2021;25(2):217-221. DOI: 10.35975/apic.v25i2.1474 Received: 11 January 2021, Reviewed: 15 January 2021, Accepted: 16 February 2021

scholarly journals Recurrent Sigmoid Volvulus – Early Resection may Obviate Later Emergency Surgery and Reduce Morbidity and Mortality

2009 ◽  
Vol 91 (3) ◽  
pp. 205-209 ◽  
Author(s):  
JO Larkin ◽  
TB Thekiso ◽  
R Waldron ◽  
K Barry ◽  
PW Eustace
Keyword(s):  
Emergency Surgery ◽  
Hospital Admissions ◽  
Elective Surgery ◽  
Postoperative Mortality ◽  
Operative Management ◽  
Sigmoid Volvulus ◽  
High Rate ◽  
Colonoscopic Decompression ◽  
Non Operative Management ◽  
Overall Mortality

INTRODUCTION Acute sigmoid volvulus is a well recognised cause of acute large bowel obstruction. PATIENTS AND METHODS We reviewed our unit's experience with non-operative and operative management of this condition. A total of 27 patients were treated for acute sigmoid volvulus between 1996 and 2006. In total, there were 62 separate hospital admissions. RESULTS Eleven patients were managed with colonoscopic decompression alone. The overall mortality rate for non-operative management was 36.4% (4 of 11 patients). Fifteen patients had operative management (five semi-elective following decompression, 10 emergency). There was no mortality in the semi-elective cohort and one in the emergency surgery group. The overall mortality for surgery was 6% (1 of 15). Five of the seven patients managed with colonoscopic decompression alone who survived were subsequently re-admitted with sigmoid volvulus (a 71.4% recurrence rate). The six deaths in our overall series each occurred in patients with established gangrene of the bowel. With early surgical intervention before the onset of gangrene, however, good outcomes may be achieved, even in patients apparently unsuitable for elective surgery. Eight of the 15 operatively managed patients were considered to be ASA (American Society of Anesthesiologists) grade 4. There was no postoperative mortality in this group. CONCLUSIONS Given the high rate of recurrence of sigmoid volvulus after initial successful non-operative management and the attendant risks of mortality from gangrenous bowel developing with a subsequent volvulus, it is our contention that all patients should be considered for definitive surgery after initial colonoscopic decompression, irrespective of the ASA score.

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