AN AUDIT OF LAPAROTOMIES;

Objective: To make an audit of laparotomies carried out at Combined Military Hospital Pano Aqil over a three year period.Study design: Cross sectional, retrospective study. Place and duration of study: Study was carried out at surgical department ofcombined military hospital Panno Aqil over a period of three years from Jan 2009 to Dec 2011. Patients and methods: Patients withsignificant intra-abdominal pathology presenting as acute abdomen and who underwent laparotomy were included in study. Patientswere either electively admitted via outpatient department or through Accident and Emergency (A&E) department. Patient charts andrecords were used to collect data. Results: All 174 patients underwent laparotomy. In (27.6%) cases, intestinal perforation was theunderlying cause; gynaecological pathology was found in (21.2%) patients. In 19.5% cases blunt and penetrating abdominal trauma wasthe cause of acute abdomen. Acute intestinal obstruction was found in (21.3%), tumors were found in (7.9%) and miscellaneous causeswere identified in (2.3%) cases. Conclusions: Laparotomies carried out at Combined Military Hospital Pano Aqil fulfilled the evidencebased medicine criteria.

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STUDY IN PAEDIATRIC AGE GROUP UNDERGOING EMERGENCY LAPAROTOMY : OBSERVATIONAL STUDY

10.36106/ijsr/6529703 ◽

2021 ◽

pp. 1-2

Author(s):

Akash KR. Gupta ◽

Manoj KR Das ◽

Marshal D Kerketta

Keyword(s):

Intestinal Obstruction ◽

Acute Abdomen ◽

Gastrointestinal Diseases ◽

Acute Intestinal Obstruction ◽

Emergency Laparotomy ◽

Age Group ◽

Common Cause ◽

Colonic Atresia ◽

Paediatric Age ◽

Perforation Peritonitis

INTRODUCTION: Acute abdomen can be defined as “syndrome included by wide variety of pathological conditions that require emergent medical or more often surgical management.” Acute abdomen is caused due to gastrointestinal diseases such as intestinal obstruction and perforation peritonitis. AIM: The aim of our study was to observe the common cause in paediatric age group undergoing emergency laprotomy in our institutions. MATERIAL AND METHODS:This prospective study included 77children aged below or equal to 15years, underwent emergency laprotomy for acute intestinal conditions between January 2019 to December 2019 in RIMS,RANCHI. We excluded neonates ,patients of jejunoileal colonic atresia and stenosis, anorectal malformation(ARM), congenital pouch colon, neonatal necrotizing enterocolitis(NEC), hirschprung’s disease, gastrointestinal tumor. RESULTS: Total of 77 laprotomies were performed in emergency in children below or equal to 15 years age,59(76.62% ) were boys and 18(23.37% )were girls with male:female ratio of 3.2:1. 36(46.75%) cases were done for acute intestinal obstruction and 41(53.24%) cases were done for perforation peritonitis.20(25.97%)emergency laprotomy was performed in the age group 1-5 years and 57(74.02% ) were performed in the age group 5-15 years. Causes in order of frequency for intestinal obstruction were intussusceptions, post operative band/adhesion, abdominal tb obstruction, meckel’s diverticulum and worm obstruction. Causes in order of frequency for perforation peritonitis were typhoid, abdominal tb, appendicular perforation and abdominal trauma. CONCLUSION: In our study maximum emergency laprotomy was performed in male patients with male:female ratio of 3.2:1. Perforation peritonitis was more common than acute intestinal obstruction. 5-15 year age group were more commonly affected. Typhoid ileal perforation was the most common cause for emergency laprotomy followed by intussusception.

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A CROSS-SECTIONAL STUDY OF STANDARD INTERVENTION OF INTESTINAL OBSTRUCTION IN A TERTIARY HOSPITAL IN CENTRAL INDIA.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i4.1932 ◽

2021 ◽

Vol 5 (4) ◽

Author(s):

Kunwar Anees Ahmad Khan

Keyword(s):

Intestinal Obstruction ◽

Surgical Techniques ◽

Central India ◽

Signs And Symptoms ◽

Tertiary Hospital ◽

Acute Intestinal Obstruction ◽

Morbidity Rate ◽

Postoperative Adhesions ◽

Cross Sectional ◽

Stomach Pain

Background: A common surgical emergency, intestinal blockage has a high death and morbidity rate. Intestinal blockage accounts for about 15% of all emergency room visits for acute abdominal discomfort. Acute intestinal obstruction can take several forms, ranging from a seemingly normal look with just minor stomach pain and distension to a situation of hypovolemic or septic shock (or both) requiring an emergency treatment. Aim: The goal of this study was to see how our tertiary hospital managed intestinal obstruction operations. Material and Methods: Patients in the current study ranged in age from 21 to 80 and had a surgically treated acute intestinal blockage. Patients with severe signs and symptoms of acute blockage were treated with an appropriate surgical approach after initial resuscitation. All of the data was entered into a spreadsheet and analysed with descriptive statistics. Results: During the study period, 288 patients received surgery for acute intestinal blockage. The most prevalent age group (26 percent) was 51 to 60 years old, followed by 41 to 50 years old (21 percent ). Male patients were 2.8 times more likely than female patients to be afflicted. Previous abdominal surgery (56 percent), diabetes (31%), smoking (25%), hypertension (24%), and bronchial asthma/ COPD (15%) were all discovered to be common co-morbidities in this study. The most common causes of intestinal obstruction in this study were postoperative adhesions (47 percent), malignancy (15 percent), obstructed hernia (11 percent), and Koch's abdomen (8 percent ). The most prevalent surgical procedures in this study were adhesion removal (47 percent), resection and anastomosis (22 percent), diversion colostomy (13 percent), and hernioplasty (13 percent) (11 percent ). Fever (15%) and wound infection (11%) were the most prevalent post-operative problems, respectively. The rate of post-operative death was 13%. There are nine patients in all. The majority of deaths are caused by complications such as septicemia, peritonitis, and lung infection. Conclusion: Postoperative adhesions are a common cause of intestinal blockage. Early surgical techniques, when combined with clinical diagnosis and radiological data, may improve the outcome of acute intestinal obstruction. Keywords: surgical management, acute intestinal obstruction, adhesions, adhesiolysis.

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STUDY OF SURGICAL MANAGEMENT OF INTESTINAL OBSTRUCTION FROM CENTRAL INDIA: A CROSS SECTIONAL STUDY

Journal of medical pharmaceutical and allied sciences ◽

10.22270/jmpas.v10i3.1231 ◽

2021 ◽

Vol 10 (3) ◽

pp. 3070-3073

Author(s):

Samadhan Patil

Keyword(s):

Abdominal Pain ◽

Intestinal Obstruction ◽

Surgical Management ◽

Central India ◽

Signs And Symptoms ◽

Tertiary Hospital ◽

Acute Intestinal Obstruction ◽

Postoperative Adhesions ◽

Cross Sectional ◽

Mortality And Morbidity

Intestinal obstruction is a common surgical emergency with high mortality and morbidity rates. About 15% of all emergency room visits for acute abdominal pain are due to intestinal obstruction. Acute intestinal obstruction may manifest in a variety of ways, from a relatively normal appearance with only minor abdominal pain and distension to a condition of hypovolemic or septic shock (or both) that necessitates an emergency procedure. In present study we aimed to evaluate surgical management of intestinal obstruction at our tertiary hospital. The current research included patients aged 21 to 80 who had an acute intestinal obstruction that was surgically treated. After initial resuscitation, patients with strong signs and symptoms of acute obstruction were treated with an appropriate surgical procedure. All of the information was recorded in a preformat and analysed using descriptive statistics. 144 patients had surgery for acute intestinal obstruction during the study period. 51 to 60 years old was the most common age group (26 %), followed by 41 to 50 years old (21 %). In a ratio of 2.8:1, male patients were more frequently affected than female patients. Previous abdominal surgery (56 %), diabetes (31 %), smoking (25 %), hypertension (24 %), and bronchial asthma/ COPD (15 %) were all found to be common comorbidities in this research. Postoperative adhesions (47 %), malignancy (15 %), obstructed hernia (11 %), and Koch's abdomen were the most common causes of intestinal obstruction in this report (8 %). Adhesiolysis (47 %), resection and anastomosis (22 %), diversion colostomy (13 %), and hernioplasty were the most common surgical procedures in this study (11 %). The most common post-operative complications were fever (15%) and wound infection (11%) respectively. The post-operative mortality rate was 13%. (9 patients). Complications such as septicaemia, peritonitis, and respiratory infection account for the majority of deaths. Intestinal obstruction is often caused by postoperative adhesions. Early operative procedures, in combination with clinical diagnosis and radiological findings, may enhance the outcome of acute intestinal obstruction.

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Long Term Effect of Acute Intestinal Obstruction Management following Laparotomy in a Tertiary Care Hospital

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v7i2.49595 ◽

2020 ◽

Vol 7 (2) ◽

pp. 73-79

Author(s):

Md Mamunur Rahman ◽

Nelema Jahan ◽

Md Mahfuzul Momen ◽

Syed Masud Reza ◽

Karina Rahman ◽

...

Keyword(s):

Intestinal Obstruction ◽

Complication Rate ◽

Tertiary Care ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Acute Intestinal Obstruction ◽

Care Hospital ◽

Surgical Morbidity ◽

Cross Sectional ◽

Long Term Effect

Background: Post-surgical outcomes are very crucial for acute intestinal obstruction following laparotomy. Objective: The purpose of the present study was to identify the causes and risk factors that influence the outcome of post laparotomy acute intestinal obstruction and also to assess their management and outcome. Methodology: This cross sectional study comprising fifty patients irrespective of age and sex with diagnosis of Acute intestinal obstruction following laparotomy who attended at the Department of Surgery in different tertiary Hospital of Dhaka city, within the time period of July 2017 to June 2019. All these data were analyzed and tried to find out the outcome of management of acute intestinal obstruction following laparotomy. Results: All the 50 patients had undergone some conventional surgeries in previous instance. Acute intestinal obstruction was found in 80.0% of cases who had undergone emergency surgery and 20.0% cases were after routine surgery. The reasons behind Laparotomy for burst appendix (16.0%) followed by laparotomy for blunt trauma abdomen (12.0%) and classical appendicectomy (12.0%). After conservative management complication rate was low (21.0%) and the most prominent complication was UTI (28.57%) whereas mortality was 14.29%. After surgical management complication rate was higher which was in 56.25% of cases. Conclusion: Post laparotomy of acute intestinal obstruction can improve the outcome and reduce the chance of relaparotomy, surgical morbidity. Journal of Current and Advance Medical Research 2020;7(2): 73-79

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Diagnosis and surgical treatment of acute intestinal obstruction caused by extragenital form of endometriosis

HERALD of North-Western State Medical University named after I I Mechnikov ◽

10.17816/mechnikov202012197-101 ◽

2020 ◽

Vol 12 (1) ◽

pp. 97-101

Author(s):

Zemlyanoy V. Р. P. Zemlyanoy ◽

B. V. Sigua ◽

D. S. Syomin ◽

D. V. Gurzhiy ◽

D. H. Qalandarova

Keyword(s):

Surgical Treatment ◽

Gastrointestinal Tract ◽

Intestinal Obstruction ◽

Sigmoid Colon ◽

Clinical Laboratory ◽

Acute Intestinal Obstruction ◽

Intestinal Lumen ◽

Childbearing Age ◽

Surgical Department ◽

Extragenital Endometriosis

Damage to the gastrointestinal tract with extragenital endometriosis is a very rare pathology. According to the literature, the frequency of damage to the gastrointestinal tract in endometriosis, after previously performed gynecological operations, is less than 1%. At the same time, involvement in the pathological process of the intestine is noted in 337% of women of childbearing age with diagnosed genital endometriosis. In most clinical cases extragenital endometriosis occurs intraoperatively due to the complexity of early diagnosis. This article presents a clinical case of successful surgical treatment of a 43-year-old patient admitted to a surgical department with signs of intestinal obstruction. According to the anamnesis the patient had been suffering from recurrent pains in the lower abdomen in the right mesogastrium and constipation. The day before hospitalization, the above mentioned symptoms become worse with additional nausea, vomiting, lack of gases and feces. Based on the clinical laboratory and instrumental data the diagnosis of acute intestinal obstruction was established; and the urgent surgical treatment was carried out. Two formations were revealed intraoperatively (in the terminal ileum and in the elongated loop of the sigmoid colon). Both formations circularly narrowed the intestinal lumen, however the ileum was the cause of obstruction. Due to the lack of histological verification and the inability to exclude the malignant nature of the formation, the surgical treatment was carried out taking into account oncological standard in the amount of ileum resection and obstructive resection of the sigmoid colon with lymphadenectomy and small intestine intubation. Pathohistological examination confirmed intestinal endometriosis. The course of the postoperative period revealed no complications. The patient was discharged on the 12th day for outpatient treatment under the supervision of a surgeon and a gynecologist at the place of residence with recommendations and subsequent planned hospitalization in order to conduct reconstructive surgery to restore intestinal patency.

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COLONIC DUPLICATIONS, COMPLICATED BY ACUTE INTESTINAL OBSTRUCTION IN A 9-YEAR-OLD GIRL

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-4-194-197 ◽

2021 ◽

Vol 100 (4) ◽

pp. 194-197

Author(s):

O.V. Sherbakova ◽

◽

L.R. Khabibullina ◽

A.N. Fersauli ◽

T.D. Kostomarova ◽

...

Keyword(s):

Congenital Anomaly ◽

Gastrointestinal Tract ◽

Intestinal Obstruction ◽

Intestinal Perforation ◽

Acute Intestinal Obstruction ◽

Intestinal Bleeding ◽

Rare Congenital Anomaly ◽

Ectopic Tissue ◽

Staged Treatment ◽

Colon Duplication

Gastrointestinal tract (GIT) duplication is a rare congenital anomaly with an incidence of about 1 in 4,500 newborns. Duplication of the intestine, as a rule, is diagnosed at 2–3 years, however, cases of this pathology being detected in patients of any age are described. Duplication of GIT can be asymptomatic or be detected when massive intestinal bleeding, intestinal perforation, obstruction due to intussusception or volvulus, and even malignancy in the doubled section occur. The characteristic signs of a duplication of the intestine are a well-developed muscular membrane, a general blood supply to the duplication with a portion of the supporting intestine, the presence of a mucous membrane that coincides with the supporting segment, in a third of cases, ectopic tissue is found. Our article describes the staged treatment of a patient with total tubular colon duplication complicated by acute intestinal obstruction.

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Accuracy of Bisap Score to Predict Severe Acute Pancreatitis Keeping Ranson Score as Gold Standard

10.53350/pjmhs2115103426 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3426-3428

Author(s):

Muhammad Rehan Khan ◽

Tayyaba Mushtaq Khan ◽

Syed Munim Hussain ◽

Syed Mukarram Hussain

Keyword(s):

Acute Pancreatitis ◽

Diagnostic Accuracy ◽

Severe Acute Pancreatitis ◽

Gold Standard ◽

Cross Sectional Study ◽

Military Hospital ◽

Cross Sectional ◽

Serum Lipase ◽

Surgical Department ◽

Ranson Score

Objective: To ascertain the diagnostic accuracy of BISAP score to predict severe acute pancreatitis keeping Ranson score as gold standard Study design: Descriptive Cross Sectional study Place and duration of study: Surgical Department, Combined Military Hospital Rawalpindi from January 2017 to July 2017. Methodology: 65 patients having history indicative of acute pancreatitis, serum lipase and serum amylase were measured. Patients with confirmed diagnosis of acute pancreatitis who consented for taking part in the research and achieving the inclusion and exclusion criteria were enrolled for study. Patients were evaluated by adequate history and thorough examination. All patients are investigated for Ranson score and BISAP score and divided into mild and severe pancreatitis on the basis of BISAPS and Ranson scoring. Results: In our study, mean+sd age was 44.92+8.92 years. Frequency of severe acute pancreatitis was 32.3%. Diagnostic accuracy of BISAP score to predict severe acute pancreatitis keeping Ranson score as gold standard had 80.9% of sensitivity, 81% of specificity, 68% of PPV and 90% of NPV. Conclusion: BISAP score have an excellent accuracy for prediction of severe acute pancreatitis as Ranson score. BISAP score can be used as tool for recognition of severe acute pancreatitis within 24 hours in simple and precise manner. Keywords: Severe acute pancreatitis, Prediction, BISAP score, Ranson score, Accuracy

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Relationship between Inferior Thyroid Artery and Recurrent Laryngeal Nerve - A Study of 200 Cases

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v22i2.45089 ◽

2020 ◽

Vol 22 (2) ◽

pp. 60-65

Author(s):

Muhammad Ali Azad ◽

AKM Asaduzzaman ◽

Mohammad Delwar Hossain ◽

Faysal Bin Mohsin ◽

Abdullahis Safi

Keyword(s):

Retrospective Study ◽

Recurrent Laryngeal Nerve ◽

Laryngeal Nerve ◽

Inferior Thyroid Artery ◽

Military Hospital ◽

Cross Sectional ◽

Time Period ◽

Anatomical Knowledge ◽

Pass Through ◽

The Right

Introduction: Thyroid surgery is a common modality of treatment for both benign and malignant thyroid disorders.Relationship between inferior thyroid artery (ITA) and recurrent laryngeal nerve (RLN) is crucial in preservation of recurrent laryngeal nerve. Thorough anatomical knowledge and meticulous surgery will ensure the integrity of recurrent laryngeal nerve. Objective: The purpose of this study is to observe the anatomical position of recurrent laryngeal nerve in relation to inferior thyroid artery which will eventually lead to identification of recurrent laryngeal nerve peroperatively. Methods: A cross sectional retrospective study was conducted during the time period of 1st January 2013 to 31st December 2015 in Combined Military Hospital, Dhaka among 200 patients who had undergone thyroidectomy. Results: In this series on the right side 71.8% cases RLN was dorsal to ITA, 21.7% cases it was ventral and in 6.5% cases RLN runs in between the branches of ITA. In case of left side 74.5% cases RLN was dorsal to ITA, 22.5% cases it was ventral and in 3% cases RLN runs in between the branches of ITA. Conclusion: Usually RLN runs dorsal to ITA. In left side it is deeper and in case of right side it is more superficial. RLN may pass through the branches of ITA, but it is not very common. Bangladesh J Otorhinolaryngol; October 2016; 22(2): 60-65

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An Assessment of the Nurses’ Knowledge and Practices of Inpatient Fall Prevention

International Archives of Medicine ◽

10.3823/2622 ◽

2020 ◽

Vol 13 ◽

Author(s):

Quang-Tri LE ◽

Huong-Giang Tran-Thi ◽

Minh-Kha Tran

Keyword(s):

Internal Medicine ◽

Fall Prevention ◽

Fall Risk ◽

Descriptive Study ◽

Ho Chi Minh City ◽

Military Hospital ◽

Cross Sectional ◽

Surgical Department ◽

Preventive Practices ◽

Female Nurses

Purposes: We conducted a cross-sectional descriptive study to evaluate the knowledge and practices of fall prevention among nurses in four departments in 7A Military Hospital, Ho Chi Minh City, Vietnam. Subjects and methods: Sixty-two nurses in four departments were chosen to fulfill pre-designed questionnaires, and their daily fall preventive practices were observed. Results: There were 40.3% of nurses achieve good knowledge of fall prevention. In practice, 22.5% of nurses had proper compliance, and 77.4% had not. 82.3% of nurses claimed to update fall prevention knowledge often, and 87.1% demanded training for fall prevention. Nurses in the surgical department group had more knowledge of fall prevention than nurses in the internal medicine group of departments (68.7% vs. 10.0%, p<0.05). Female nurses had higher fall risk compliances than males (78.3% vs. 37.5%, P<0.05). Conclusion: Training for nurses in fall preventive knowledge and practices are needed in 7A Military Hospital. Keywords: fall preventive; nurses; questionnaires; risk compliances.

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Strangulated intestinal obstruction with extensive necrosis of the small intestine in an elderly patient

Kazan medical journal ◽

10.17816/kazmj84487 ◽

1981 ◽

Vol 62 (5) ◽

pp. 69-70

Author(s):

D. M. Krasilnikov ◽

A. D. Dzamukov ◽

R. V. Yunusov

Keyword(s):

Elderly Patient ◽

Abdominal Pain ◽

Intestinal Obstruction ◽

Acute Intestinal Obstruction ◽

Surgical Department ◽

First Time ◽

Extensive Necrosis ◽

Severe Weakness ◽

Over Time ◽

Emergency Doctors

Diagnosis and treatment of acute intestinal obstruction is extremely difficult, especially in elderly and senile people. I., 90 years old, was admitted to the surgical department on 14 / ІХ 1980 at 21 hours with complaints of severe abdominal pain of a constant nature, vomiting of bile, stool retention, severe weakness. Suddenly fell ill on 13 / IX: at 9 o'clock there were severe cramping pains in the abdomen, vomiting, severe weakness. Over time, the pain became constant, vomiting did not stop. Within 36 hours before admission to the surgical department, the patient was repeatedly examined by emergency doctors. In 1970, the patient underwent surgery for gangrenous appendicitis. Such an attack marks the first time.

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