scholarly journals SIGMOID VOLVULUS

2018 ◽  
Vol 25 (10) ◽  
pp. 1562-1567
Author(s):  
Ali Akbar Ghumro ◽  
Altaf Hussain Ghumro ◽  
Abdul Hakeem Jamali
Keyword(s):  
Primary Repair ◽  
Primary Anastomosis ◽  
Single Layer ◽  
Developed Countries ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
High Morbidity ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Medical University

Introduction: Sigmoid volvulus is the surgical emergency and significant causeof large bowel obstruction in with high morbidity and mortality. Disease is more prevalent indeveloping countries than developed countries. It contributes 15% of total bowel obstruction.Resection and primary anastomosis is the procedure of choice. It obviates the need ofcolostomy and subsequent reversal. Objectives: To determine the frequency of postoperativecomplications of primary repair in patients with either viable or gangrenous sigmoid volvulus.Study Design: Retrospective study. Setting: Surgical Unit 1 of Peoples Medical CollegeHospital now Medical University. Period: 2007 to Dec. 2013. Methodology: Patients with largebowel obstruction suspected to have sigmoid volvulus on clinical and radiological grounds werestudied. Laparotomy and resection of sigmoid colon followed by restoration of the continuity ofthe colon by single layer primary anastomosis were performed without colostomy. Results: In atotal 50 patients, sigmoid volvulus male female ratio was 9:1. Mean age was 49 years majority ofthe patients were in 6th to 7th decade of age. In 96% cases abdominal pain was the 1st symptomfollowed by constipation and distention, vomiting was the rare symptom. Different postoperativecomplication results were surgical site infection was the commonest complication in 40 (80%)while in 1 (2%) leak was there with mortality of only 1(2%) case. Conclusion: Primary resectionand single stage anastomosis is the best choice for the management of sigmoid volvulusdisease in both possibilities of viable or non viable gut provided patients condition is stable. Itobviates the burden of colostomy

scholarly journals Early Outcome of Laparoscopic Abdominoperineal Resection, Our Experience in Bangabandhu Sheikh Mujib Medical University

2014 ◽  
Vol 8 (2) ◽  
pp. 53-55
Author(s):  
Mohammed Tanvir Jalal ◽  
Shahadot Hossain Sheikh ◽  
Md Rayhanur Rahman ◽  
Mesbah Uddin Noman ◽  
Jesmin Akhter Leena ◽  
...  
Keyword(s):  
Abdominoperineal Resection ◽  
Operative Procedure ◽  
Operation Time ◽  
Postoperative Outcomes ◽  
Female Ratio ◽  
Early Outcome ◽  
Male Female Ratio ◽  
Laparoscopic Abdominoperineal Resection ◽  
Medical University ◽  
Age Range

Anorectal malignancies that require abdominoperineal resection (APR) is very common. Laparoscopic APR can be a better option. Laparoscopic APR has been seldom studied. This study aims to evaluate perioperative and early postoperative outcomes of laparoscopic APRs performed for the treatment of ano-rectal carcinomas. Patients operated for ano-rectal carcinoma between June 2011 to June 2013 in Bangabandhu Sheikh Mujib Medical University (BSMMU) were observed. Demographics, tumor and procedure-related parameters, perioperative results, early postoperative outcomes and survival were observed. Total 22 patients were under went laparoscopic APR. Male: Female ratio was 15:7 (68.18%: 31.82%). Age range was from 30-65 years with a mean age of 36.55 years. Mean operation time was 165 minutes and mean post-operative hospital stay was 6.8 days. Overall complication rate was 45.45%. Laparoscopic APR is a safe, effective and technically feasible procedure. It can be a better operative procedure than open APR. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20281 Faridpur Med. Coll. J. 2013;8(2): 53-55

scholarly journals Colorectal Adenocarcinoma in East Africa: A Narrative Literature Review

2020 ◽  
pp. 1-11
Author(s):  
Richard Wismayer
Keyword(s):  
East Africa ◽  
Colorectal Adenocarcinoma ◽  
Significant Proportion ◽  
Developed Countries ◽  
East African ◽  
African Countries ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Usa ◽  
Narrative Literature Review

This paper is a review of work done on colorectal adenocarcinoma in East Africa showing geographic spread, age and sex ratios, clinical presentation, management and predominant histopathology. A steady increased incidence of CRC in East African countries is currently being documented however this is associated with a higher CRC-associated morbidity and mortality. Whilst the male: Female ratio varies between 1.2:1 to 1.88:1, up to 38% of CRC diagnosis are in patients younger than 40 years, in contrast to only 1.9% of CRC patients in Western developed countries such as the USA. Generally rectal carcinoma is more common than colon carcinoma and abdomino-perineal resections are commonly performed in up to between 54% - 71% due to the advanced stage of presentation of rectal tumours in East Africa. The late stage presentation and delayed effective treatment in East Africa may result in a higher morbidity in CRC patients. Interestingly there is a significant incidence of mucinous adenocarcinoma sub-groups compared to Western developed countries which carry a poor prognosis. A significant proportion of CRC patients have been found to have histological and demographic features which suggest that MSI-tumours and these tumours are more common in younger patients. However only a few authors have looked at the possibility of mismatch repair mutations in the genetic aetiopathogenesis of colorectal adenocarcinoma in East Africa.

scholarly journals Review of Management of Ileosigmoid Knotting

2021 ◽  
pp. 1-4
Author(s):  
Seke Manase Ephraim Kazuma ◽  
Seke Manase Ephraim Kazuma ◽  
Bright Chirengendure ◽  
Luyando Simunyama ◽  
Kamwi Mundia ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
Electrolyte Balance ◽  
High Morbidity ◽  
Rare Type ◽  
Risk Of Mortality ◽  
Contrast Enhanced ◽  
Intestinal Continuity ◽  
Gangrenous Bowel

Ileosigmoid knotting (ISK) is a rare type of intestinal obstruction caused by knotting of the mesentery of the ileum or sigmoid colon that rapidly progresses to gangrene with a high risk of mortality and high morbidity. The incidence of ISK is not well established, but it is higher in regions with high rates of sigmoid volvulus and in countries along the sigmoid belt. Clinical presentation is that of both small-bowel and large bowel obstruction and includes vomiting and nausea, abdominal pain, tenderness, and distention, with constipation. A contrast-enhanced computer tomography (CT) scan is the preferred modality for imaging. Management involves hemodynamic stabilisation with correction of shock using aggressive fluid resuscitation, electrolyte balance and commencement of antibiotics. Principles of surgery include resection of the knot, resection of the gangrenous bowel and establishing intestinal continuity. The outcome is generally complicated by peritonitis and sepsis that lead to mortality.

scholarly journals Is single-stage resection and anastomosis for acute sigmoid volvulus, without intra operative colonic lavage a safe procedure?

2021 ◽  
Vol 28 (06) ◽  
pp. 872-875
Author(s):  
Muhammad Bilal ◽  
Viqar Aslam ◽  
Waqas Jan ◽  
Zaheer Udin
Keyword(s):  
Primary Anastomosis ◽  
Mechanical Bowel Preparation ◽  
Sigmoid Volvulus ◽  
Single Stage ◽  
Safe Procedure ◽  
Local Data ◽  
Cross Sectional ◽  
Female Ratio ◽  
Colonic Lavage ◽  
Resection And Anastomosis

Objective. This study was conducted to provide local data regarding the results and post-operative complications after single-stage resection and anastomosis for acute sigmoid volvulus, without intra operative colonic lavage. Study Design: Descriptive Cross Sectional. Setting: DHQ Charsadda. Period: May 2017 to December 2019. Material & Methods: This clinical study was done on 50 patients who presented with the signs and symptoms of acute sigmoid volvulus excluding those with complications of the illness such as gangrene, perforation and peritonitis. Surgery for all patients was carried out under General anaesthesia. All the patients underwent emergency resection and primary anastomosis, without mechanical bowel preparation. Data were collected regarding post operation complication and analysis by using SPSS version 23. Chi square test was used to compare at level of significance <0.005. Results: Median age of patients was 50 years with male to female ratio 5:3. Seven patients presented with wound infection, one dehiscence while zero Anastomotic leakage and zero death postoperative recorded. Conclusion:  Single stage resection and primary anastomosis without preoperative colonic lavage for acute sigmoid volvulus is a simpler and short procedure with low mortality and morbidity rates.

scholarly journals A clinical study on the management of sigmoid volvulus

2017 ◽  
Vol 4 (3) ◽  
pp. 1039
Author(s):  
M. Ramula Durai ◽  
J. Kiran Kumar ◽  
. Vijayanand
Keyword(s):  
Tamil Nadu ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
Primary Resection ◽  
Safe Procedure ◽  
Management Options ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Primary Resection And Anastomosis

Background: Sigmoid volvulus is a surgical emergency and significant cause of large bowel obstruction with high mortality and morbidity. The disease is more prevalent in India, especially rural population. It constitutes 15% of total bowel obstructions. This study analyzes various management options in our institute which caters mainly to patients from the surrounding rural areas.Methods: The present work is study of 36 cases, carried out as regards to the etiological factors which predispose to the sigmoid volvulus, the clinical features, modes of treatment and the outcome. Particular stress has been laid on the various treatments. The duration study was 2 years between November 2014 and October 2016 at Government Chengalpattu medical college, Tamil Nadu, India.Results: The mean age of sigmoid volvulus was 49 years (range 19-75) and male to female ratio was 2:1. Comparatively less frequent in less than 20 years and above 70 years. Distention of abdomen (100%), followed by constipation in 88% were common mode of presentation. Sigmoidopexy done in 22% patients with nil mortality and, for primary resection and anastomosis, it was 17%. Common post-operative complication found to be wound infections.Conclusions: Primary resection anastamosis is found to be definitive safe procedure if the colon is viable. Hartman’s procedure is suitable only if the bowel is gangrenous. Absence of co morbid conditions a notable feature. Pre operative X-RAY helpful in diagnosis. Mortality found to be 17.5% in our study.

scholarly journals Infections in Children with Newly Diagnosed Idiopathic Nephrotic Syndrome

2013 ◽  
Vol 12 (3) ◽  
pp. 1-4
Author(s):  
Shanjoy Kumar Paul ◽  
Quazi Rakibul Islam ◽  
Golam Muin Uddin ◽  
M Moazzam Hossain
Keyword(s):  
Nephrotic Syndrome ◽  
Fungal Infections ◽  
Pediatric Nephrology ◽  
Watery Diarrhea ◽  
Female Ratio ◽  
Medical College ◽  
Acute Watery Diarrhea ◽  
Different Types ◽  
Male Female Ratio ◽  
Medical University

Patients with nephrotic syndrome (NS) are susceptible to different types of bacterial, viral & fungal infections. This prospective observational study was performed in the Pediatric Nephrology unit of Bangabandhu Sheikh Mujib Medical University, Dhaka from January, 2006 to May, 2008 to determine the types of infection associated with initial attack of idiopathic NS and to alert the physicians about this so that they can take preventive and therapeutic measures more promptly. 112 admitted children aged one to fifteen years with first attack of idiopathic NS were included. After control of existing infection, prednisolone was given in recommended dose & duration. All patients were followed for development of any type of new infection up to completion of treatment. Mean age was 61.87 months & male female ratio was 1.49:1. Most patients (78.57%) had been suffering from different types of infection on admission with male preponderence (59.09%) & most were under-6 years old (67.04%). During prednisolone therapy, 29.46% patients developed infections, 63.64% were male and under-6 years old were 72.73%. Fever, cough, abdominal pain & loose motion were the commonest presentations related to infection. Acute respiratory infection (ARI), acute watery diarrhea & urinary tract infection (UTI) were the most common infections on admission (53.57%, 34.82%, and 7.14% respectively). ARI & oral thrush were commonest infections during treatment with prednisolone (14.27% & 12.50% respectively). Infection should be ruled out carefully in every case of NS at each visit and during management in hospital & outside to reduce morbidity & mortality. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 1-4

scholarly journals Sigmoid Volvulus in the Developing Countries: The Lack of Resources Might be a Blessing in Disguise

2021 ◽  
Author(s):  
Atef MEJRI ◽  
Khaoula Arfaoui ◽  
Sarra Saad ◽  
Jasser Rchidi ◽  
Ahmed Omri ◽  
...  
Keyword(s):  
Developing Countries ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Primary Anastomosis ◽  
Sigmoid Volvulus ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Epidemiological Features ◽  
The Mean ◽  
Gangrenous Bowel

Abstract BackgroundSigmoid volvulus is the most common type of volvulus. Its epidemiological features as well as its management differ between developed and developing countries. Tis work aims to analyze the epidemiological features and to access the surgical management of sigmoid volvulus in Tunisia, which is a developing country from North Africa and where there is a paucity of information regarding sigmoid volvulus.MethodsThis is a retrospective review of 64 patients with sigmoid volvulus treated in the General Surgery department of Jendouba Hospital in Tunisia from January 2005 to December 2019. In the absence of endoscopic management, all patients underwent surgical treatment.Results:64 patients were treated for acute sigmoid volvulus. There were 54 (84.4%) men with a male to female ratio of 5.4/1. The mean age was 62 years. The classic triad of abdominal pain, abdominal distention and constipation was reported in 56 (87.5%) patients. The mean duration of symptoms was 4.2 days. The accurate preoperative diagnosis was made in 58 (90.62%) cases. Forty patients (74%) had viable bowel obstruction and all of them had resection and primary anastomosis. Sixteen patients had gangrenous bowel obstruction of which 6 patients had resection-primary anastomosis and 10 had Hartmann’s procedure. Out of the total five deaths reported, there were only two among patients who had resection-primary anastomosis for gangrenous bowel obstruction. The commonest post-operative complication was surgical site infection in 5 cases (35.71%). The median length of hospital stay following surgery was 8 days (range 5 – 18 days). None of the patients had recurrences of volvulus after median follow up of 11 months.Conclusion Although Tunisia belongs to the volvulus belt, the epidemiologic features of sigmoid volvulus are not similar to those reported in the other African countries and tend rather to be similar to those of developed countries. Our results show that the absence of non-operative treatment can be tolerable and surgical management should be advocated as much as possible.

scholarly journals A Comparative Study on Efficacy of Methotrexate and Sulphasalazine in Spondyloarthropathies

2011 ◽  
Vol 24 (1) ◽  
pp. 43-47
Author(s):  
NS Afsar ◽  
MMN Khan ◽  
MMH Chowdhury ◽  
SA Haq ◽  
M Khalilur Rahman ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Disease Duration ◽  
Wide Spectrum ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Mean ◽  
The Difference ◽  
Medical University ◽  
Active Disease

Background: Spondyloarthropathies include a wide spectrum of disease. The study was conducted with the aim of observing the efficacy of SSZ and MTX in different subclasses of spondyloarthropathies and to compare the treatment response of the two drugs. Methods: This study was conducted in the Department of Medicine and Rheurnatology clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) between January 1999 and July 2001.A total number of one hundred twenty five patients was included in the study. Patients with active disease more than three months, regularly taking NSAIDs and not on DMARD in the last three months were included in the study. Monthly follow up of the patients was done for 6 months. Result: One hundred twenty five patients were included in this study. Male female ratio was 11.5:1. Mean age of patients was 24.17±7.15 years. The mean disease duration was 47.8±32.8 months. The present study categorized the patients into responder and non responder. Among the 78 patients in AS subclass, after completion of 6 month trial 55.6% patients in SSZ group and 39.4% patients in MTX group were categorized responder. The difference of response between drug groups was not significant (p=0.158). In the JCA subclass 81.82% in SSZ and 50% in MTX group were responder. The numbers of patient in Reiter's/Reactive Arthritis in our study were too small to make a definite comment. Conclusion: It can be concluded from this study that both the SSZ and MTX are effective DMARDs for spondyloarthropathies. Statistical analysis did not prove superiority of one drug over another, though the response rates were numerically higher in SSZ group. TAJ 2011; 24(1): 43-47

scholarly journals Acute Pesticide Poisoning: Review of Patients Attending at Emergency Department in Chitwan Medical College

2013 ◽  
Vol 3 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Daya Ram Lamsal
Keyword(s):  
Emergency Department ◽  
Case Fatality ◽  
Acute Poisoning ◽  
High Morbidity ◽  
Pesticide Poisoning ◽  
Female Ratio ◽  
Medical College ◽  
Patient Status ◽  
Male Female Ratio ◽  
Acute Pesticide Poisoning

To find out the hospital based incidence, pattern and fatality of acute pesticide poisoning which may be helpful to develop better management strategy and preventive campaign. A total of 88 patients were reported in emergency with acute pesticide poisoning out of 178 total acute poisoning cases resulting in APP rate 49.43% of total poisoning cases. Male: Female ratio was 1:1.5. The age group specific incidence of acute poisoning showed 7.95% in 0-14 years, 45.55% in 15-29 years 30.68% in 30-44 years and 12.50% in 45-59 years and3.40% in 60 years and above. Out of 88 patients 79.55% admitted,20.45% of patient status was unknown as these patients were referred or refused admission. lost follow up .Among admitted patients 8.57% died and 91.43% dischared from hospital. Maximum case fatality ratio (28.57%) was due to endosulfan poisoning. Pesticide is responsible in 49.43% of all poisoning patients visiting to emergency department with the mortality of 6.80% among pesticide poisoning, Women have high morbidity but man predominantly exceeds on mortality rate.. Highest case fatality observed among the endosufan exposed group. How patients are getting such toxic poisons and why these victims are being exposed needs further study. Emphasis on case management and preventive campaigns would have some impact in reducing morbidity and mortality from acute pesticide poisoning. Journal of Chitwan Medical College 2013; 3(1): 62-64 DOI: http://dx.doi.org/10.3126/jcmc.v3i1.8469

Evaluation of the Operative Treatment in Chronic Haematogenous Pyogenic Osteomyelitis by Sequestrectomy and Saucerisation in Children

2018 ◽  
Vol 5 (1) ◽  
pp. 15-20
Author(s):  
Md Mamun Or Rashid ◽  
Md Aminur Rahman ◽  
AKM Anisuzzaman Choudhury ◽  
Khursheda Akhtar ◽  
Khodeza Akhtar
Keyword(s):  
Surgical Treatment ◽  
Chronic Osteomyelitis ◽  
Age Group ◽  
Proper Selection ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Pyogenic Osteomyelitis ◽  
A Prospective Study ◽  
Medical University ◽  
Selection Of

Background: Complete resolution occurs in many other types of infections with the use of antibiotics but not always with chronic pyogenic osteomyelitis.Objective: The aim of the present study was to evaluate the effectiveness of most conventional method of surgical treatment of chronic pyogenic osteomyelitis by sequestrectomy and saucerisation in Children.Methodology: This present study was a prospective study conducted at Bangabandhu Shekh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2015 to December 2016 for a period of two (2) years. Patients aged up to 16 years were included in the study. Purposive sampling was done.  Only chronic osteomyelitis of haematogenous origin were included after proper selection of the patients. Sequestrectomy and saucerisation was done. Wound was kept open and allowed to heal from bottom and sides of the wound.Result: A total 36 patients aged up to 16 years were included in the study. Among the cases two third were male 26(72.23%) and rest were female 10(27.77%). The male female ratio was 2.6:1.Therefore the incident was significantly high in males (p<0.01). Most of the patients 28(77.77%) were in 6 to 16 age group, which was significantly high (p<0.01) and mean age was 9.83years. Average time taken for wound healing was 3.75 weeks. Regarding antibiotics, Cap Flucloxacillin was the maximum choice.  Patients were followed up to maximum 2 years and evaluated clinically and radiologically. Maximum patients 31(86.10%) had satisfactory (good and fair) outcome, but only 5(13.88%) patients had poor outcome. There was a significant association among sequestrectomy and saucerisation with final outcome (p<0.001).Conclusion: It was concluded that describing operative technique is still method of choice for surgical treatment of chronic haematogenous pyogenic osteomyelitis.Bangladesh Journal of Infectious Diseases 2018;5(1):15-20

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