scholarly journals The non traumatic acute abdomen and its clinical spectrum

2019 ◽  
Vol 6 (5) ◽  
pp. 1710
Author(s):  
M. Srujan Kumar ◽  
Bharath B. ◽  
K. S. Balasubramanya ◽  
K. Thinagaran
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Clinical Examination ◽  
Open Appendectomy ◽  
Postoperative Outcome ◽  
Exploratory Laparotomy ◽  
Medical Sciences ◽  
Female Ratio ◽  
Perforative Peritonitis ◽  
General Surgeons

Background: Acute abdomen poses a big challenge to the general surgeons in terms of both diagnosis and management. The aim of this study was to know in detail the clinical and postoperative outcome in non traumatic acute abdomen.Methods: Prospectively collected data of 326 patients with non traumatic acute abdomen admitted in PES institute of medical sciences and research, Kuppam from November 2016 to June 2018. All patients were subjected to clinical examination, relevant blood and imaging investigations, Intra and postoperative findings events were recorded.Results: Non traumatic acute abdominal pain was more common in 2nd to 5th decade of life. Males are more affected than females with a male to female ratio of 3.4:1. Acute appendicitis forms the commonest cause of acute abdomen (n=160=49%) followed by perforative peritonitis (n=85=26%). Most common surgical procedures done were laparoscopic/open appendectomy for acute appendicitis, exploratory laparotomy with Graham’s omentoplasty for perforative peritonitis.Conclusions: Systematic approach in history taking and a proper clinical examination with supportive imaging findings are most important in making an accurate diagnosis and need of appropriate surgical intervention in patients with non traumatic acute abdomen.

scholarly journals Effect of Early Surgery on Outcome In Perforation Peritonitis

2018 ◽  
Vol 5 (1) ◽  
pp. 12-16
Author(s):  
Tika Ram Bhandari ◽  
Rajesh Poudel ◽  
Kailash Chandra
Keyword(s):  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Exploratory Laparotomy ◽  
Normal Diet ◽  
Early Surgery ◽  
Medical Sciences ◽  
Late Intervention ◽  
Perforation Peritonitis ◽  
Independent Risk Factors ◽  
Early Surgical Intervention

BACKGROUND: Early diagnosis and emergent surgical management of perforation peritonitis remain the mainstay of treatment. The aim of study was to find the effect of early surgery on postoperative outcome in patients with perforation peritonitis.MATERIALS & METHODS: A retrospective medical report of 200 patients who underwent exploratory laparotomy and proceed for perforation peritonitis from July 2015 to December 2016 was studied. Patients were divided into two groups based on the time of surgery i.e: Early (<6 hours) and late (≥6 hours) intervention groups. All perioperative outcome of surgery were analyzed.RESULTS: Late intervention patients were more likely to develop complications (34.3 and 17.8%, P < 0.05) and mortality (14 and 6%, P<0.05) in comparison to early intervention patients and had significantly higher median time to resumption of normal diet (5and 2.8 days, length of hospital stay (15 and 9 days) and length of ICU stay (8 and 4 days) (P < 0.05). The time to operation (≥ 6 hours) and preoperative hypotension were independent risk factors for postoperative complications in multivariate analysis.CONCLUSION: Early surgical intervention within six hours along with broad spectrum antibiotics preceded by adequate aggressive resuscitation improves postoperative outcomes in perforation peritonitis.Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, page: 12-16

Thirty-day postoperative outcome of patients with non-traumatic gastroduodenal perforations in southwestern Uganda

2019 ◽  
Vol 50 (1) ◽  
pp. 15-19
Author(s):  
Ronald Okidi ◽  
Vanusa D Sambo ◽  
Martin D Ogwang ◽  
David Mutiibwa ◽  
Noralis P Benitez ◽  
...  
Keyword(s):  
Postoperative Outcome ◽  
Exploratory Laparotomy ◽  
Unique Challenge ◽  
Female Ratio ◽  
Regional Referral Hospital ◽  
Gastroduodenal Perforation ◽  
H Pylori ◽  
One Year ◽  
Southwestern Uganda ◽  
Male To Female

We studied our 30-day postoperative outcomes in patients with non-traumatic gastroduodenal perforation (NTGDP) in Mbarara Regional Referral Hospital, southwestern Uganda. We conducted a one-year prospective study of patients who underwent exploratory laparotomy for suspected NTGDP between June 2016 and July 2017. Twenty-nine patients had NTGDP, the male-to-female ratio was 3:1 and median age was 60 years (range = 13–80 years). Most (83%) patients were negative for Helicobacter pylori on histology. One patient had a gastric adenocarcinoma. A total of 26 (90%) patients had Graham's omentopexy performed. The 30-day mortality rate was 34%. Pyrexia at hospital admission, pre-surgical delay (> 72 h), preoperative shock and peritoneal contamination, were associated with higher mortality rates with preoperative shock being an independent predictor of mortality. H. pylori-negative NTGDP presents a unique challenge in our setting, affecting mainly middle-aged and elderly patients. One-third of our patients did not survive one month.

scholarly journals Retrospective analysis of laparoscopic versus open appendectomy for the treatment of acute appendicitis

2020 ◽  
Vol 7 (12) ◽  
pp. 4045
Author(s):  
Ritvik Resutra ◽  
Haroon Salaria ◽  
Rajive Gupta
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Routine Activity ◽  
Laparoscopic Technique ◽  
Time Duration ◽  
Jammu And Kashmir ◽  
Post Operative Pain ◽  
General Surgeons

Background: Acute appendicitis is one of the most commonly encountered emergency by the general surgeons and appendectomy is the most common surgery performed in the world. Although open appendectomy is preferred by many surgeons, yet the laparoscopic approach is gradually replacing open surgery for treatment of acute appendicitis.Methods: A total of 400 patients of acute appendicitis were operated, 200 by laparoscopic appendectomy and 200 by open method by a single surgeon at various private hospitals in Jammu (Jammu and Kashmir), India over a period of three years from July 2017 to July 2020. The two groups were compared with respect to operative time, duration of hospital stay, post-operative pain, complication rate and time taken to resume routine activity and cosmetic satisfaction of the patients.Results: Results were found to be better with the laparoscopic technique. There was significantly less pain in the postoperative period with faster recovery, early resumption to work, reduced postoperative complications and better cosmetic satisfaction of the patients operated by the laparoscopic appendectomy technique as compared to open surgery.Conclusions: Laparoscopic appendectomy is safe and feasible technique in expert hands, for treatment of acute appendicitis with results comparable to the open appendectomy, with no obvious increase in complications and is definitely a procedure of choice for the management of acute appendicitis.

scholarly journals Prevalence of Acute Abdomen Admission in Surgery Ward at Tertiary Care Center of Nepal

2019 ◽  
Vol 7 (1) ◽  
pp. 14-16
Author(s):  
Rajesh Poudel ◽  
Kailash Chandra ◽  
Santosh Shah ◽  
Naveen Mahasheth ◽  
Santosh Mishra ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Acute Cholecystitis ◽  
Acute Abdomen ◽  
Care Center ◽  
Tertiary Care ◽  
Emergency Admission ◽  
Descriptive Study ◽  
Medical Sciences ◽  
Few Data ◽  
Diagnosis Age

INTRODUCTION: Abdominal pain is one of the most common reasons for an emergency department visit, accounting to about 8% of all emergency visits in United States. There are very few data available regarding the emergency admission of acute abdomen in Nepal. The aim of this study is to determine the prevalence of acute abdomen admission and their frequency according to the age, sex and month of admission in hospital.  MATERIAL AND METHODS: This was a retrospective descriptive study carried out in Universal College of Medical Sciences, Bhairahawa, Nepal. Admission registers of surgery ward from July 2017 to June 2018 were reviewed. Data regarding the diagnosis, age, sex and month of admission of the patients were collected. Descriptive analyses were done regarding the frequency of disease, distribution of the diseases according to the age, sex and month of occurrences.  RESULTS: Total of 675 patients with acute abdomen were analyzed. Acute appendicitis was the most common cause for acute abdomen accounting for 52% of total admission. It was followed by intestinal obstruction (13%) and acute cholecystitis (11%). Median age of presentation of acute appendicitis was 23 years. Median age of presentation of acute cholecystitis was 42 years. Acute abdomen occured most frequently on April, May and December. Overall, spring season had highest number of admission (31.5%) followed by winter (25.6%).  CONCLUSION: Acute abdomen incidence varies according to age, most commonly found in young adults. Male has higher prevalence of acute abdomen when compared to female with exception of acute cholecystitis.

scholarly journals Diagnosis and management of acute appendicitis by Alvarado scoring with ultrasonography as supportive tool

2017 ◽  
Vol 4 (8) ◽  
pp. 2806 ◽  
Author(s):  
Chenna Krishna Reddy Chada ◽  
Srikrishna Malepati ◽  
Jithendra Kandati ◽  
Sreeram Satish
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Open Appendectomy ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Predictive Values ◽  
Female Ratio ◽  
Male Predominance ◽  
Sensitivity Specificity

Background: Acute appendicitis remains as one of the most common surgical entity requiring early intervention. Delay in management results in complications and misdiagnosis results in negative appendectomy. Hence there is always a need to develop a well-designed protocol for diagnosis and to reduce negative appendectomy. Alvarado score for diagnosis of acute appendicitis is an easy, affordable and diagnostic which has been evaluated early with variable reports. In cases with equivocal score, additional tools like sonography may provide a reliable result in accurate diagnosis of acute appendicitis. Objective of the study was to determine the diagnostic accuracy of Alvarado score and ultrasonography in diagnosis of acute appendicitis. To determine the sensitivity, specificity and predictive values of ultrasonography in cases operated with histopathological correlation.Methods: A prospective observational study was conducted at our hospital by department of general surgery for a period of six months. All suspected cases of appendicitis were scored by Alvarado score and cases with>5 were performed additional USG for further evaluation. All the cases of appendicitis that underwent surgery were further confirmed by histopathological correlation with USG and clinical Alvarado score.Results: A total of 200 cases were enrolled with male predominance (57.5%) and mean age of study group was 34.26±8.64 years and male to female ratio of 1.3:1.69% of cases presented with Alvarado score of 7 and above, while 21% of cases with 5-6. Migratory pain in RIF was the commonest symptom and tenderness RIF was the most common sign.160 cases (80%) were operated totally with 75% cases lap appendectomy and 25% cases by open appendectomy. USG was performed on 160 cases and 146 were positive and 14 were negative whereas histopathologically 142 cases were confirmed as Acute appendicitis. The sensitivity, specificity, PPV and NPV of USG is 97.18%, 55.56%, 94.52% and 71.43%. The accuracy of USG is 92.5.Conclusions: Acute appendicitis is first and foremost a clinical diagnosis with scoring systems and imaging being necessary adjuncts in equivocal cases. USG is an easily available tool in diagnosis of acute appendicitis. Application of USG as adjunct tool to Alvarado scoring improves the diagnostic accuracy.

scholarly journals Comparison of clinical examination and ultrasonography in the diagnosis of acute appendicitis

2012 ◽  
Vol 7 (2) ◽  
pp. 34-40
Author(s):  
PK Chhetri ◽  
A Tayal ◽  
PK Deka
Keyword(s):  
Acute Appendicitis ◽  
Clinical Examination ◽  
Histopathological Examination ◽  
Imaging Modality ◽  
Iliac Fossa ◽  
Clinical Impression ◽  
Medical Sciences ◽  
Right Iliac Fossa Pain ◽  
Diagnostic Work ◽  
Work Up

This study was undertaken to compare clinical examination and ultrasonography (USG) in the diagnosis of acute appendicitis and to establish their accuracy in the diagnosis of acute appendicitis. 100 patients who presented to the emergency department with a clinical diagnosis of acute appendicitis were subjected to USG. After USG a specific diagnosis was made. Patients underwent appendicectomy on the basis of the surgeon‘s final clinical impression after correlating with USG findings. Histopathological examination of the appendicectomy specimen was taken as the gold standard for the diagnosis of acute appendicitis. Appendicectomy was performed in 74 patients. Out of these 74 cases, only 66 had appendicitis on histopathological examination. Eight normal appendixes were removed. Twenty-six patients were prevented from surgery after USG had shown an alternative diagnosis for the cause of pain in right iliac fossa. Clinical examination thus had a sensitivity and Positive Predictive Value (PPV) of 66%. USG examination made a preoperative diagnosis of acute appendicitis in 62 of the 66 patients. However the remaining 4 cases with appendicitis were missed by USG. USG had a sensitivity of 93.93%, specificity of 100%, PPV of 100%, NPV of 89.47% and an overall accuracy of 96% in the diagnosis of acute appendicitis. USG is thus a sensitive and specific imaging modality in the diagnostic work up of patients with right iliac fossa pain. USG may improve the diagnostic accuracy in patients with suspected acute appendicitis.Journal of College of Medical Sciences-Nepal, 2011, Vol-7, No-2, 34-40DOI: http://dx.doi.org/10.3126/jcmsn.v7i2.6678

An Uncommon An Uncommon Cause of Acute Abdomen in Underprivileged Communities

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
David Muchuweti ◽  
Hopewell Mungani ◽  
Hopewell Mungani ◽  
Farai Mahomva ◽  
Edwin Gamba Muguti ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Acute Abdomen ◽  
Bowel Obstruction ◽  
Bowel Wall ◽  
Haemodynamic Instability ◽  
Small Bowel Volvulus ◽  
General Surgeons ◽  
Heavy Infestation ◽  
Emergency Abdominal Surgery

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.

Mini-incision open appendectomy: An analysis of 70 cases of acute appendicitis

2019 ◽  
Vol 10 (2) ◽  
pp. 65-67
Author(s):  
Kunal Babulal Pisre ◽  
◽  
Pravin Govande ◽  
Satish Gireboinwad ◽  
◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Open Appendectomy ◽  
Mini Incision

A Rare Cause of Mechanical Intestinal Obstruction: A Neoplastic Intra-Abdominal Testis

2016 ◽  
Vol 101 (3-4) ◽  
pp. 167-170
Author(s):  
Fatih Ciftci ◽  
Suat Benek ◽  
Cem Kezer
Keyword(s):  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Undescended Testis ◽  
Abdominal Mass ◽  
Relevant Literature ◽  
Large Diameter ◽  
Exploratory Laparotomy ◽  
Clinical Findings ◽  
Surgical Units ◽  
Mechanical Intestinal Obstruction

The acute abdomen has many etiologies frequently encountered in emergency surgical units. Approximately 20% of surgical admissions for acute abdominal conditions are for intestinal obstruction. Clinicians often overlook rarer causes. A 43-year-old man presented to the emergency ward with the clinical findings of ileus. Computed tomography revealed a heterogeneous necrotic 168 × 100-mm mass between the sigmoid colon and urinary bladder. Physical examination revealed a palpable intra-abdominal mass that was removed via exploratory laparotomy. On histopathologic examination, the mass was identified as a seminoma. The literature contains few reports of seminoma as a cause of acute abdomen and ileus, mostly seen between the ages of 30 and 40 years. We report a patient with seminoma arising in an undescended testis that presented as a palpable painful lower abdominal mass and mechanical intestinal obstruction, despite the large diameter of the mass, as well as review relevant literature.

scholarly journals Adenocarcinoma Ex Goblet Cell Carcinoid of Appendix: Two Case Reports

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Yu-Ting Wang ◽  
Yi-Ru Li ◽  
Tuan-Ying Ke
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Goblet Cell ◽  
Case Reports ◽  
Biological Behavior ◽  
Rare Tumor ◽  
Goblet Cell Carcinoid

Adenocarcinoma ex goblet cell carcinoid is a rare tumor incidentally found in specimens of appendicitis. Most patients present with acute abdomen, similar to acute appendicitis. Here we present two cases, which were found incidentally after operation. We give a brief summary about clinical and biological behavior of this entity.

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