Management of Infections with Mycobacterium Other Than Tuberculosis (MOTT) as a Complication of Surgical Procedures.

2020 ◽  
Author(s):  
Bikash Naskar
Keyword(s):  
Exploratory Laparotomy ◽  
Human Pathogens ◽  
Antitubercular Drugs ◽  
Laparoscopic Hernioplasty ◽  
Sensitivity Report ◽  
Drug Regimens ◽  
Combination Antibiotics ◽  
Conventional Antibiotics ◽  
Mesh Hernioplasty

Abstract BACKGROUND:Atypical mycobacteria (MOTT) have emerged as significant human pathogens, causing post-surgical wound infections.The aim of this study is to assess the causative organisms of such infection and their treatment response.METHODS:After matching the criteria, 28 cases, were taken for this prospective, single center, observational study.The diagnosis was confirmed by bacterial culture. RESULTS:Among 28 patients, 16 were females (median age of 45.5 year). Patients had undergone laparoscopic cholecystectomy ( n=13 ), laparoscopic appendicectomy ( n=3), laparoscopic hernioplasty ( n=2 ), open appendicectomy ( n=2 ), open mesh hernioplasty ( n= 7 ), exploratory laparotomy (n=1 ). No major comorbidities or immunosuppression was identified. All patients were initially treated with repeated incision and drainage and started conventional antibiotics until culture and sensitivity report was available.All except one patient had culture confirmed MOTT infection. Combination antibiotics (clarithromycin, linezolid and ofloxacin ) given for initial 3 months. 12 well responded within 3 months. 9 required additional few months to get complete cure. 4 patients cured after 6 months of treatment and 3 patients did not come for follow up.CONCLUSIONS:Delayed onset chronic wound infection by Atypical mycobacteria is preventable.These organisms are not responsive to conventional antitubercular drugs but to specific drug regimens.

scholarly journals Management of infections with Mycobacterium other than tuberculosis as a complication of surgical procedures

2020 ◽  
Vol 7 (7) ◽  
pp. 2275
Author(s):  
Bikash Naskar ◽  
Sabyasachi Bakshi ◽  
Tapas Mandal
Keyword(s):  
Exploratory Laparotomy ◽  
Human Pathogens ◽  
Antitubercular Drugs ◽  
Laparoscopic Hernioplasty ◽  
Sensitivity Report ◽  
Drug Regimens ◽  
Combination Antibiotics ◽  
Conventional Antibiotics ◽  
Mesh Hernioplasty ◽  
Mycobacterium Other Than Tuberculosis

Background: Atypical Mycobacterium other than tuberculosis (MOTT) have emerged as significant human pathogens, causing post-surgical wound infections. The aim of this study is to assess the causative organisms of such infection and their treatment response.Methods: After matching the criteria, 28 cases, were taken for this prospective, single center, observational study. The diagnosis was confirmed by bacterial culture.Results: Among 28 patients, 16 were females (median age of 45.5 year). Patients had undergone laparoscopic cholecystectomy (n=13), laparoscopic appendicectomy (n=3), laparoscopic hernioplasty (n=2), open appendicectomy (n=2), open mesh hernioplasty (n=7), exploratory laparotomy (n=1). No major comorbidities or immunosuppression was identified. All patients were initially treated with repeated incision and drainage and started conventional antibiotics until culture and sensitivity report was available. All except one patient had culture confirmed MOTT infection. Combination antibiotics (clarithromycin, linezolid and ofloxacin) given for initial 3 months. 12 well responded within 3 months. 9 required additional few months to get complete cure. 4 patients cured after 6 months of treatment and 3 patients did not come for follow up.Conclusions: Delayed onset chronic wound infection by atypical mycobacteria is preventable. These organisms are not responsive to conventional antitubercular drugs but to specific drug regimens.

scholarly journals Comparison of prolene with parietex composite® mesh in laparoscopic intraperitoneal mesh hernioplasty for paraumbilical hernia.

2021 ◽  
Vol 29 (01) ◽  
pp. 13-18
Author(s):  
Ahsan Nasim ◽  
Pir Muneeb Rehman ◽  
Kamran Ali ◽  
Naila Jabbar
Keyword(s):  
Intestinal Obstruction ◽  
P Value ◽  
Composite Mesh ◽  
Paraumbilical Hernia ◽  
Laparoscopic Hernioplasty ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Mesh Hernioplasty

Objective: To compare the outcomes of prolene macroporous mesh with Parietex Composite® mesh in patients undergoing Laparoscopic hernioplasty for management of Paraumbilical hernia. Study Design: Prospective Comparative study. Setting: Jinnah Hospital Lahore. Period: 1st January 2016 to 1st January 2018. Material & Methods: A total of 100 patients with diagnosis of Paraumbilical hernia, aged >18 years were included. There were two groups. In group A (n=50) prolene macroporous mesh (Covidien) was placed. In group B (n=50) Parietex Composite® mesh (Covidien) was placed. After hernioplasty all patients were followed for a period of 2 years for evaluation of primary procedure and any complications like seroma, hematoma and intestinal obstruction. Results: The mean length of stay was 2.74±2.13 days in group A, versus 2.23±1.25 in group B (p-value 0.15). Seroma formation was seen in 4 (8.0%) patients in group A versus in 02 (4.0%) patients in group B (p-value 0.40). Hematoma formation was seen in 01 (2.0%) patients in group A versus 0.0% patients in group B (p-value 0.10). There was no recurrence and intestinal obstruction in any group in two years follow up. Conclusion: There was no difference in surgical outcome and the complication between two groups of patients undergoing laparoscopic Paraumbilical hernia repair with prolene macroporous and Parietex Composite mesh. Moreover, parietex composite mesh are difficult to insert and much expensive. Therefore, prolene mesh can be safely used in patients undergoing Laparoscopic Paraumbilical hernioplasty.

BLUNT ABDOMINAL TRAUMA WITH HAEMOPERITONEUM TREATED BY EXPLORATORY LAPAROTOMY VERSUS ONLY ABDOMINAL DRAINAGE: A PROSPECTIVE AND COMPARATIVE STUDY.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Dhawal Panchal ◽  
Firdaus Dekhaiya ◽  
Harin Tailor
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Exploratory Laparotomy ◽  
Blunt Injury ◽  
Abdominal Drainage ◽  
Duration Of Hospital Stay ◽  
Considerable Morbidity ◽  
Injured Patients

In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied  which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients. Keywords:  Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.

scholarly journals 950 Experience of Inguinal Mesh Hernioplasty Under Local Anaesthesia: A 3-Year Experience in A Teaching Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Hashmi ◽  
R Ahmed ◽  
T Zafar ◽  
M Ahmed ◽  
N Yousaf ◽  
...  
Keyword(s):  
Local Anaesthesia ◽  
Groin Pain ◽  
Clinical Judgement ◽  
Chronic Groin Pain ◽  
Day Case ◽  
Post Operative Pain ◽  
The Mean ◽  
Mesh Hernioplasty ◽  
Operating Surgeon

Abstract Objective To prove Inguinal mesh hernioplasty under L/A is safe and acceptable. Helps with post-operative pain and enables rapid recovery as a day case. Method All patients who underwent inguinal hernia repair under local anaesthesia were retrospectively analysed in our hospital between July 2014- July 2017. Clinical judgement was used for inclusion and exclusion parameters. Results From July 2014- July 2017, 260 patients were included in study who underwent Inguinal mesh hernioplasty under L/A. ASA grade for all patients ranged between I-III. The mean age was 37 (20-65). Intraoperatively (9.1) 3.5% patients had problems such as pain, hypotension or sweating. About (86.3%) 224 patients were discharged home the same day and remaining stayed overnight for less than 24 hours. Hematoma was seen in 5 (1.92%) patients, Urinary retention in 2 (0.7%) patients, Wound infection seen in 24(9.2%) patients, Readmission in 10 (3.8%) patients. Chronic groin pain was seen in 10 (3.9%) patients and no recurrence on 6 months follow up. Conclusions Our results showed that this procedure is feasible under L/A and can be performed safely. It showed satisfactory acceptance by the operating surgeon and patient, without significant perioperative issues. It is reliable and showed shorter hospital stay.

scholarly journals Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy

2005 ◽  
Vol 33 (3) ◽  
pp. 360-363 ◽  
Author(s):  
A Polychronidis ◽  
AK Tsaroucha ◽  
AJ Karayiannakis ◽  
S Perente ◽  
E Efstathiou ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Large Bowel ◽  
Thermal Injury ◽  
Clinical Signs ◽  
Exploratory Laparotomy ◽  
Hepatic Flexure ◽  
Temporary Ileostomy ◽  
Delayed Perforation

We report a case of delayed perforation of the large bowel because of thermal injury during a laparoscopic cholecystectomy. A 78-year-old male with symptomatic cholelithiasis underwent a difficult laparoscopic cholecystectomy because of multiple adhesions resulting from two previous cholecystitis episodes. The patient recovered well after surgery and was discharged on post-operative day 2. On postoperative day 10, the patient returned to the hospital with peritonitis. An exploratory laparotomy revealed perforation of the wall of the hepatic flexure of the large bowel, which was centred in a necrotic area 1 cm in diameter. The perforation was sutured and a temporary ileostomy performed, which was closed at a later date. The patient was doing well at a 10-month follow-up review. A delayed rupture of any part of the bowel after laparoscopic surgery can be potentially fatal if not treated during an emergency exploratory laparotomy, even if the clinical signs are not severe.

scholarly journals The clinical study of the incisional hernia and its management

2017 ◽  
Vol 4 (7) ◽  
pp. 2281
Author(s):  
Navdeep Garg ◽  
Pooja Batra ◽  
Sharadendu Bali
Keyword(s):  
Incisional Hernia ◽  
Previous History ◽  
Exploratory Laparotomy ◽  
Suture Repair ◽  
Age Group ◽  
Common Complication ◽  
Response Sets ◽  
History Of ◽  
Sublay Mesh ◽  
Mesh Hernioplasty

Background: Hernia is defined as abnormal protrusion of viscus through a normal or abnormal weakness in the wall of its containing cavity. Incidence of Incisional hernias is 60%. It is the most common complication after exploratory laparotomy followed by LSCS.Methods: Data was collected for 30 cases of incisional hernia according to the proforma which included detailed history, clinical examination and investigation. Data was tabulated, analyzed and results interpreted.Results: Incisional hernia was more common in females with the ratio 1.5:1. The incidence of incisional hernia was highest in the age group ranging from 30-50 years. Most of the patients presented with chief complaint of swelling (100%) followed by pain and swelling (24%). Incisional hernia was more common in patients of previous history of abdominal procedures (explorative laparotomy 53%) followed by gynaecological operations (23%). Out of 30 patients studied, 20 underwent only mesh hernioplasty (67%), 10 underwent sublay mesh hernioplasty (23%).Conclusions: With prosthetic mesh, defects of any size can be repaired without tension. The polypropylene mesh, by inducing inflammatory response sets up scaffolding that in turn induces the synthesis of collagen. Thus, the superiority of mesh repair over suture repair can be accounted for. 

scholarly journals A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

2018 ◽  
Vol 5 (3) ◽  
pp. 1083
Author(s):  
Samrat Sunkar ◽  
Dick B. S. Brashier ◽  
Kiran Bhagwat ◽  
Vipin Sharma ◽  
Piyush Angrish
Keyword(s):  
Groin Pain ◽  
Sensory Loss ◽  
Chronic Groin Pain ◽  
Inguinal Hernioplasty ◽  
Nerve Preservation ◽  
Pain Disability ◽  
Group A ◽  
Group B ◽  
Mesh Hernioplasty

Background: Residual neuralgia, called as Inguinodynia, is an important complication unique to groin hernia repair. The reported incidence ranges between 9-63%. The symptoms are potentially disabling. Symptoms are often more pronounced on axial twisting of body. Methods for prevention include identification and preservation of all nerves, Ilioinguinal Neurectomy and triple Neurectomy during surgery.Methods: One hundred patients underwent elective unilateral Lichtenstein’s tension free hernioplasty. 50 patients were subjected to elective ilioinguinal neurectomy. The remaining underwent standard Liechtenstein’s mesh hernioplasty, without ilioinguinal neurectomy. Randomization was achieved by allocating alternate patients to each group - prophylactic neurectomy, or nerve preservation. All patients, during each review were asked to fill out a Pain Disability Questionnaire to assess sensory loss and pain disability objectively.Results: At completion of 6 monthly follow up pain at rest (none in group ‘A’ compared with 3 in group ‘B’), after coughing 5 times (none in group ‘A’ compared with 7 in group ‘B’), after climbing 4 flights of stairs(3 in group ‘A’ compared with 16 in group ‘B’) and after cycling for 20 minutes (11 in group ‘A’ compared with 22 in group ‘B’) were all significantly lesser in the neurectomy group as compared with the non neurectomy group. More importantly, exertional chronic pain incidence at 6 months was significantly less in group ‘A’.Conclusions: It was concluded that pain after inguinal mesh hernioplasty is a cause of morbidity, pain was complained of by a significantly larger number of non-neurectomised patients at 6 months of follow-up, prophylactic ilioinguinal neurectomy is associated with reduced exertional chronic groin pain, disability caused by pain after inguinal hernioplasty, is significantly reduced by ilioinguinal neurectomy and an extremely significant reduction in the requirement of medication is brought about by neurectomy compared with controls. 

scholarly journals Treatment outcome of tubercular lymphadenopathy cases treated under dots: a five year follow up study

2017 ◽  
Vol 5 (10) ◽  
pp. 4578
Author(s):  
Rajendra P. Takhar ◽  
Prateek Kothari ◽  
Shanti K. Luhadiya ◽  
Narendra K. Gupta
Keyword(s):  
Lymph Node ◽  
Relapse Rate ◽  
Treatment Completion ◽  
Antitubercular Drugs ◽  
Follow Up Study ◽  
Study Population ◽  
Lymph Node Tuberculosis ◽  
Population Treatment

Background: Treatment of tubercular lymphadenopathy consists of at least 6 months of therapy with antitubercular drugs as DOTS in India. Some studies recommend that extension of therapy for some time may lead to lesser recurrence and relapse. This study was planned to assess the outcome of DOTS therapy in lymph node tuberculosis (TB) cases treated under RNTCP and to find out the prevalence of relapse in these patients in southern Rajasthan.Methods: This was a retrospective analysis of 275 cases of lymph node tuberculosis treated with DOTS under RNTCP. An immediate outcome of these cases was recorded and further traceable 81 patients were interviewed for long term outcome.Results: In our study population, treatment completion rate was 93.09%, defaulter rate was 4% and death reported in 3.7% (3/81) cases. We observed relapse rate of 9.1% after treatment completion. A total of 7.04% patients received extended treatment and none of them had relapsed during our follow up.Conclusions: Our study confirms that the efficacy of DOTS treatment is quite good in cases of tubercular lymphadenopathy but still requires review of programmatic strategy. An extension of antitubercular therapy is recommended because patients treated with DOTS had a little higher relapse rate in comparison to whom the treatment extended who had no recurrence and relapse.

scholarly journals Jejuno-jejunal intussusception secondary to diffuse intestinal lipomatosis

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Renee Angela Tabone ◽  
Tom DeGreve ◽  
Peita Webb ◽  
Peter Yuide
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Endoscopy ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Adult Intussusception ◽  
Structural Abnormality ◽  
Successful Approach ◽  
Rare Diagnosis

Abstract A 25-year-old man presented to the emergency department with severe abdominal pain and vomiting. He had previously presented 10 days prior with similar symptoms. Computed tomography imaging showed a large jejuno-jejunal intussusception. Multiple intestinal masses were identified intraoperatively with the rare diagnosis of intestinal lipomatosis later confirmed via histopathology. Diagnosis and management of rare surgical pathologies is always challenging. Intussusception should always be considered as a differential diagnosis for abdominal pain in adults, as adult intussusception is typically due to a structural abnormality with majority of cases requiring surgical intervention. Exploratory laparotomy with segmental resection and primary anastomosis proved to be a successful approach in our case, with the patient having an uneventful recovery. Follow-up has consisted of gastrointestinal endoscopy and colonoscopy, which have not demonstrated any further lipomas.

scholarly journals Ileosigmoid knotting: an unusual cause of acute intestinal obstruction with bowel gangrene

2019 ◽  
Vol 12 (5) ◽  
pp. e226663
Author(s):  
Raj Kumar ◽  
Pavan Kumar Shamanur Kenchappa ◽  
Kusum Meena ◽  
Brijesh Kumar Singh
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Bowel Obstruction ◽  
Exploratory Laparotomy ◽  
Large Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Haemodynamic Instability ◽  
Ileocolic Anastomosis ◽  
Bowel Gangrene

Ileosigmoid knotting (ISK) is a rare cause of intestinal obstruction rapidly progressing to bowel gangrene. It is characterised by the wrapping of loops of ileum and sigmoid colon around each other. The condition often remains undiagnosed preoperatively; however, it can be suspected by the triad of small bowel obstruction, radiographic features suggestive of predominately large bowel obstruction and inability to deflate the intestine by a sigmoidoscope. We are reporting a case of 56-year-old man who presented with features of acute intestinal obstruction and compensated shock within 24 hours of onset of symptoms. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. In view of haemodynamic instability, end ileostomy was done after excising gangrenous segments. The patient improved and stoma closure and ileocolic anastomosis were done after 3 months in follow-up.

Sign in / Sign up

Export Citation Format

Share Document