Surgical management of perineal laceration in a cow affected with cervico vaginal prolapse

Author(s):  
U. Lakshmikantan ◽  
M. Murugan ◽  
A. Ganesan ◽  
T. Sathiamoorthy

A five year old cow was brought with the history of delivering the calf without untying Buhner’s suture which was applied to retain the recurrent cervico vaginal prolapse, resulting in rare occurrence of extensive laceration of perineum accompanied with cervico vaginal prolapse. Examination of perineum revealed two tears on the left lateral wall of the vagina. Absorbable suture material, poly glycolic acid (PGA) was used to appose the vaginal tears. Vulval labium was applied with simple interrupted suture using silk. Perineal repair was helpful in reconstructing the vagina and vulva. In conclusion, proper surgical apposition would restore the normal conformation of reproductive passage in cows affected with perineal laceration and Buhner’s suture should essentially be removed to avoid extensive damage to the perineum at the time of second stage parturition.

Author(s):  
Devika Perumal ◽  
Divya Selvaraju

Background: The choice of suture material for repair of episiotomy or perineal laceration is largely of one’s personal preference. Chromic catgut was widely used in most institutions. It now appears that chromic catgut is associated with more postpartum discomfort and hence chromic catgut has been largely replaced by synthetic absorbable materials like polyglactin and polyglycolic acid.Methods: The study was conducted in Institute of Social Obstetrics and Government Kasturba Gandhi Hospital, Chennai. This is a prospective, comparative study involving two groups. The use of a rapidly absorbing form of synthetic absorbable suture material, in the repair of episiotomy or perineal laceration in 100 patients during the study period February 2012 to July 2012, were simultaneously compared with the traditional natural absorbable suture material.Results: With the use of rapidly absorbing polyglactin 910, there was a significant reduction (p=0.000) in the short-term pain, 19 compared to 80 in the control group. With regard to wound dehiscence and the need for resuturing, there was statistically significant difference in the control group (15%) compared to the study group (0%). There was no statistical significance between the two groups in terms of dyspareunia (12.4% vs 10.7%).Conclusions: Fast-absorbing form of Polyglactin seems to be effective in reducing some of the morbidity associated with perineal repair following childbirth. There was significant reduction in the short-term pain and the need for analgesia. The incidence of wound dehiscence was markedly reduced.


2020 ◽  
Vol 7 (48) ◽  
pp. 2885-2887
Author(s):  
Anjali Chandrasekharan ◽  
Thasreefa Vettuvanthodi ◽  
Priya Jayasree ◽  
Suvarna Kaniyil ◽  
Nanda Lakshmi Anitha

An elderly female aged 65 years weighing 69 Kgs presented to the Pre-Anaesthetic Clinic (PAC) for transurethral resection of bladder carcinoma. As part of the evaluation of bladder carcinoma, Contrast Enhanced Computed Tomography (CECT) abdomen done showed a left adrenal lesion. She was a known case of hypertension since the last 10 years and was on telmisartan tablets 40 mg once daily (OD) since then. She had a history of palpitations 3 years back, which when evaluated was diagnosed as atrial fibrillation. She was started on metoprolol tablets 25 mg OD and warfarin 2 mg OD. In view of her history and positive findings on CECT abdomen, it was decided in the PAC to screen her for pheochromocytoma. There was no definite history of classic triad of headache, palpitation and sweating. No history of headache, weight loss, fatigue, syncopal attacks, hypo / hyperthyroidism were reported. Physical examination showed Heart Rate (HR) of 96 beats per minute (bpm), irregular in rhythm, Respiratory Rate (RR) of 16 breaths per minute and Blood Pressures (BP) of 146 / 98 mmHg and 140 / 90 mmHg in the supine and sitting positions respectively. Biochemical test results showed 24-hour urine metanephrine 0.452 mg / l which is 1.45 mg / 24 hrs. (normally < 1 mg / 24 hrs.) and urine vanillylmandelic acid 8.1 mg / gm creatinine (2 – 7 mg / gm). Electrocardiography (ECG) showed right bundle branch block and AF (Atrial Fibrillation) with controlled ventricular rate. Echocardiography showed mild aortic stenosis, aortic regurgitation and ejection fraction of 68 % with no evidence of clots / thrombus. In terms of clinical imaging, the CECT showed a well-defined lesion in the left adrenal measuring 19 x 12 mm with a relative washout of 21 % and a faint subtle hyperdense lesion in the base of left lateral wall of the urinary bladder measuring approximately 20 x 19 mm. Other blood investigations like Hb, haematocrit, urea, creatinine and blood sugars were within normal limits.


2019 ◽  
Vol 68 (12) ◽  
pp. 1523-1527
Author(s):  
Masahiro Kitada ◽  
Shunsuke Yasuda ◽  
Masahiro Abe ◽  
Nana Yoshida ◽  
Satoshi Okazaki ◽  
...  

AbstractWe experienced a surgical case of a rare primary tracheal tumor. A 77-year-old woman visited a local clinic with chief complaints of coughing, wheezing, and discomfort in the throat. Computed tomography revealed a mass measuring approximately 1.5 cm in the mediastinal trachea, extending from the membranous portion of the trachea to the esophagus. Bronchofibroscopy showed a flat, smooth-surfaced, round mass arising from the membranous portion. Surgery was performed because of the possibility of airway obstruction and suffocation. Sleeve resection of five tracheal rings was performed via median sternotomy and interrupted suture was performed using 3-0 absorbable suture material. The postoperative course was favorable and there has been no evidence of recurrence. The pathological diagnosis was solitary fibrous tumor. A primary solitary fibrous tumor of the trachea is extremely rare. Here, we report this disease with a literature review.


2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ramesh Parajuli ◽  
Suman Thapa ◽  
Sushna Maharjan

Teratomas are neoplasms derived from the germ cell with components of all the three embryonic layers. These are rare neoplasms in head and neck region which can occur in any age group but are more prevalent in children. The present case is an 11-year-old girl who was brought with history of painless and progressive swelling in the oropharynx for 3 years with the associated left sided nasal blockage and nasal discharge. CT scan was suggestive of benign nasopharyngeal mass highly suspicious for lipoma. Excision of the mass was done under general anaesthesia. Peroperatively, it was a smooth, pedunculated mass arising from the left lateral wall in the nasopharynx. On cut section, it was solid to cystic mass similar to fatty tissue. Her HPE report came out to be mature teratoma of nasopharynx.


2021 ◽  
pp. 039156032110011
Author(s):  
Armando Serao ◽  
Francesca Ambrosini ◽  
Barbara Cavallone ◽  
Tiziana Borra ◽  
Andrea Di Stasio

Introduction: Well-differentiated papillary mesothelioma (WDPM) is a very rare neoplasm. Most of WDPM are asymptomatic and are often incidentally detected during surgery. This report describes a case of WDPM of the peritoneum unexpectedly diagnosed in a male with a spontaneous intraperitoneal bladder rupture. Case presentation: A 65-year-old male presented to our Emergency Department in November 2019 with a two-day history of anuria, abdominal pain, distention, and sepsis. The CT scan reported a large amount of extra and intraperitoneal free fluid. The CT cystogram showed bladder perforations on the dome and on the left lateral wall which was repaired through exploratory laparotomy. Intraoperatively, we encountered extensive suppurative peritonitis with large fibrino-purulent exudation. The purulent perivesical peritoneum was dissected and sent for histopathological examination which unexpectedly resulted in WDPM of the peritoneum. Conclusion: Although we can’t affirm with certainty, this case would seem to suggest that WDPM had played a role in patient’s clinical presentation. However, further research is necessary to draw stronger conclusion.


2020 ◽  
pp. 1-3
Author(s):  
Hamikchandra Patel ◽  
Karan Patel

Background: The surgical treatment of inguinal hernias has evolved through several stage, history of groin hernia is the history of surgery itself. But, chronic pain is still a major irritating post-operative complain of the patient. The objective of the present study was to compare post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in terms of postoperative pain, chronic groin pain, seroma formation, wound infection and recurrence in Lichtenstein hernioplasty. Methods: This is a single centre, prospective randomized controlled study of 152 cases of inguinal hernia comparing post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in Lichtenstein hernioplasty at Baroda Medical College and S.S.G. Hospital, between 1st December 2017 to 30th November 2018. Results: Total 152 patients of unilateral or bilateral inguinal hernia were studied 76 in each group. Chronic groin pain mean visual analogue scale score at 3 months was higher in group with non-absorbable suture compared to monofilament absorbable group (1.3±0.9 v/s 0.95±0.8 p value <0.05). Conclusions: Monofilament absorbable suture is associated with less chronic groin pain and compared to monofilament non-absorbable sutures.


2019 ◽  
Vol 6 (12) ◽  
pp. 4364
Author(s):  
Karan R. Patel ◽  
Adeesh P. Jain ◽  
Sarav C. Shah ◽  
Rahul Rathwa ◽  
Kirtan Gosai

Background: The surgical treatment of inguinal hernias has evolved through several stage, history of groin hernia is the history of surgery itself. But, chronic pain is still a major irritating post-operative complain of the patient. The objective of the present study was to compare post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in terms of postoperative pain, chronic groin pain, seroma formation, wound infection, scrotal oedema and recurrence in Lichtenstein hernioplasty.Methods: This is a single center, prospective randomized controlled study of 152 cases of inguinal hernia comparing post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in Lichtenstein hernioplasty at Baroda Medical College and S.S.G. Hospital, between 1st November 2017 to 30th November 2018.Results: Total 152 patients of unilateral or bilateral inguinal hernia were studied 76 in each group. Chronic groin pain mean visual analogue scale score at 3 months was higher in group with non-absorbable suture compared to monofilament absorbable group (1.3±0.9 v/s 0.95±0.8 p value <0.05).Conclusions: Monofilament absorbable suture is associated with less chronic groin pain and compared to monofilament non-absorbable sutures.


VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Abraham Fessehaye ◽  
Ferid A. Abubeker ◽  
Mekdes Daba

Abstract Background Locked twins is a rare and hazardous obstetric complication, which occurs in approximately 1:100 twin pregnancies. One of the known etiologic factors for locked twins is size of the twins. We report a case of chin-to-chin locked twins that occurred at gestational age of 30 weeks pus 6 days. Case summary A 27 years-old primigravida Oromo mother presented with a history of pushing down pain and passage of liquor of 6 hours duration at gestational age of 30 weeks plus 6 days. With a diagnosis of twin pregnancy (first twin non-vertex), abdominal delivery was decided in latent first stage of labor but mother refused caesarian delivery and she was allowed to labor with the hope of achieving a vaginal delivery. In second stage, interlocking twin was encountered and a low vertical cesarean section was done to effect delivery of twins without the need to decapitate the first twin. Conclusion Locked twin is a rare obstetric complication. Whenever it is encountered, successful delivery can be achieved without the need to have decapitation of the first twin during caesarian section.


Author(s):  
Iris Burck ◽  
Rania A. Helal ◽  
Nagy N. N. Naguib ◽  
Nour-Eldin A. Nour-Eldin ◽  
Jan-Erik Scholtz ◽  
...  

Abstract Objectives To correlate the radiological assessment of the mastoid facial canal in postoperative cochlear implant (CI) cone-beam CT (CBCT) and other possible contributing clinical or implant-related factors with postoperative facial nerve stimulation (FNS) occurrence. Methods Two experienced radiologists evaluated retrospectively 215 postoperative post-CI CBCT examinations. The mastoid facial canal diameter, wall thickness, distance between the electrode cable and mastoid facial canal, and facial-chorda tympani angle were assessed. Additionally, the intracochlear position and the insertion angle and depth of electrodes were evaluated. Clinical data were analyzed for postoperative FNS within 1.5-year follow-up, CI type, onset, and causes for hearing loss such as otosclerosis, meningitis, and history of previous ear surgeries. Postoperative FNS was correlated with the measurements and clinical data using logistic regression. Results Within the study population (mean age: 56 ± 18 years), ten patients presented with FNS. The correlations between FNS and facial canal diameter (p = 0.09), wall thickness (p = 0.27), distance to CI cable (p = 0.44), and angle with chorda tympani (p = 0.75) were statistically non-significant. There were statistical significances for previous history of meningitis/encephalitis (p = 0.001), extracochlear-electrode-contacts (p = 0.002), scala-vestibuli position (p = 0.02), younger patients’ age (p = 0.03), lateral-wall-electrode type (p = 0.04), and early/childhood onset hearing loss (p = 0.04). Histories of meningitis/encephalitis and extracochlear-electrode-contacts were included in the first two steps of the multivariate logistic regression. Conclusion The mastoid-facial canal radiological assessment and the positional relationship with the CI electrode provide no predictor of postoperative FNS. Histories of meningitis/encephalitis and extracochlear-electrode-contacts are important risk factors. Key Points • Post-operative radiological assessment of the mastoid facial canal and the positional relationship with the CI electrode provide no predictor of post-cochlear implant facial nerve stimulation. • Radiological detection of extracochlear electrode contacts and the previous clinical history of meningitis/encephalitis are two important risk factors for postoperative facial nerve stimulation in cochlear implant patients. • The presence of scala vestibuli electrode insertion as well as the lateral wall electrode type, the younger patient’s age, and early onset of SNHL can play important role in the prediction of post-cochlear implant facial nerve stimulation.


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