scholarly journals Contribution of imaging to the management of acute generalized peritonitis in the visceral surgery department of the Sino-Guinean hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 091-096
Author(s):  
Oumar Taibata Balde ◽  
Soriba Naby Camara ◽  
Houssein Fofana ◽  
Abdoulaye Korse Balde ◽  
Mamadou Saliou Barry ◽  
...  
Keyword(s):  
Septic Shock ◽  
Abdominal Ultrasound ◽  
Morbidity Rate ◽  
Physical Sign ◽  
Pelvic Ultrasound ◽  
Male Predominance ◽  
Generalized Peritonitis ◽  
Modal Class ◽  
Life Threatening ◽  
Surgery Department

Introduction: Acute generalized peritonitis is a life-threatening emergency. It is most often secondary to a perforation of the digestive organ and or to the spread of an intra-abdominal septic area. Methodology: We carried out a descriptive retrospective study lasting from January 1, 2018 to December 31, 2018 on the contribution of imaging in the management of acute generalized peritonitis general surgery department of the hospital Chinese-Guinean. Were included in our study, all records of patients with acute generalized peritonitis will be confirmed by imaging. We carried out an exhaustive recruitment of all complete files. Our variables were analyzed using the Epi-info 7.2 software. Result: Out of 578 hospitalized patients, peritonitis represented 8.8% of cases. We noted a male predominance with 60.8% and a Sex-ratio: M / F = 1.6 whose mean age was 41.9 ± 13.5 years; extremes ranging from 17 and 67 years with a modal class ≥ 30 years or 88.3%. Housewives were the most collected with 25.5% Abdominal pain was the main reason for consultation, i.e., 90.2%, the physical sign was dominated by a convex and sensitive Douglas-fir, i.e., 27.5%. The clinical diagnosis was supported by abdomen without preparation and abdominal ultrasound; performed in 84.3% and 15.7% of patients, respectively. We noted a morbidity rate of 15.7% dominated by septic shock (15.7%). Conclusion: Our study made it possible to determine the contribution of imaging in the management. In addition, in our study, the abdomen without preparation and the abdomino-pelvic ultrasound were revealed as a key link in the management of acute generalized peritonitis.

scholarly journals A prospective study on clinical outcome of complicated external hernias

1970 ◽  
Vol 10 (1) ◽  
pp. 20-26
Author(s):  
VC Shakya ◽  
CS Agrawal ◽  
S Adhikary
Keyword(s):  
Risk Factors ◽  
Bowel Resection ◽  
Elective Surgery ◽  
High Risk Group ◽  
Morbidity Rate ◽  
Elderly Males ◽  
Life Threatening ◽  
A Prospective Study ◽  
Surgery Department ◽  
Subsequent Intervention

Background: External hernias are relatively simple diseases in themselves to treat; however, complications developing in them, such as irreducibility, obstruction and strangulation, may present as a life-threatening one. Objective: To study the characteristics of these patients and identification of risk factors that may predict development of these complications would help place the patient in a high-risk group and subsequent intervention. Methods: It is a prospective descriptive study in patients presenting to Surgery Department of BPKIHS, Dharan, Nepal with a diagnosis of complicated external hernias from December 2009 to July 2011. Results: There were a total of 63 patients including 53 males (84.1%) and 10 females (15.8%). The average age of the patients was 49.23+21.4 years (range 10 days-85 years). The average duration of hernia was 6.36+6.57 years (range 5 hours -30 years). The median duration of complications was 2 days (range 5 hours-15 years). There were 7 mortalities (11.11%). The morbidity rate was 33.33% (21 cases). Risk factors identified for mortality were age >65 years (p=0.004), inguinal hernias (p<0.001), presence of co-morbid diseases (p<0.001), presence of strangulation (p=0.007) and bowel resection (p<0.001); and for morbidities were type of hernia (p<0.001), presence of co-morbid diseases (p=0.013), and bowel resection (p=0.002). Conclusion: Elderly males with co-morbid diseases with inguinal hernia and with strangulation and needing bowel resection are most likely to die from more complications. Such patients when seen in the outpatient department should be given priority admission and taken up for early elective surgery. DOI: http://dx.doi.org/10.3126/hren.v10i1.6002 HREN 2012; 10(1): 20-26

scholarly journals Acute generalized peritonitis of appendicular origin: Epidemiological, clinical and therapeutic aspects at the Sino-Guinean Friendship Hospital

2021 ◽  
Vol 7 (2) ◽  
pp. 087-092
Author(s):  
Soriba Naby Camara ◽  
Monece Haba ◽  
Oumar Taibata Balde ◽  
Mama Aïssata Camara ◽  
Mohamed Camara ◽  
...  
Keyword(s):  
Sex Ratio ◽  
Surgical Site Infection ◽  
Acute Inflammation ◽  
Visceral Surgery ◽  
Site Infection ◽  
Male Predominance ◽  
Generalized Peritonitis ◽  
Study Results ◽  
Friendship Hospital ◽  
Surgery Department

Introduction: The aim of this study is to investigate, the etiologies, the results of management of acute generalized peritonitis of appendicular origin. Acute generalized peritonitis of appendicular origin is defined as acute inflammation of the peritoneum resulting from either perforation of the appendix or spread of a peri-appendicular abscess. Methodology: The visceral surgery department of the Sino-Guinean Friendship Hospital served as the framework for this work. All patients admitted and operated on for acute generalized peritonitis of appendicular origin whose records were complete were included in this study. Results: During our study we recorded 23 cases of appendicular peritonitis, the sex ratio of nearly 3.6 reflected a clear male predominance of the condition. We noted 15 cases of appendicular perforation, 8 cases of appendicular gangrene, 2 cases of surgical site infection, 2 cases of evisceration and 2 cases of death. Conclusion: Appendicular peritonitis is a frequent disease, the management is medico-surgical.

Effect of Undertriage on the Outcomes of Cancer Patients with Febrile Neutropenia, Sepsis, and Septic Shock

2021 ◽  
pp. 105477382199968
Author(s):  
Anas Alsharawneh
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Length Of Stay ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Emergency Setting ◽  
Extended Length ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
Timely Treatment

Sepsis and neutropenia are considered the primary life-threatening complications of cancer treatment and are the leading cause of hospitalization and death. The objective was to study whether patients with neutropenia, sepsis, and septic shock were identified appropriately at triage and receive timely treatment within the emergency setting. Also, we investigated the effect of undertriage on key treatment outcomes. We conducted a retrospective analysis of all accessible records of admitted adult cancer patients with febrile neutropenia, sepsis, and septic shock. Our results identified that the majority of patients were inappropriately triaged to less urgent triage categories. Patients’ undertriage significantly prolonged multiple emergency timeliness indicators and extended length of stay within the emergency department and hospital. These effects suggest that triage implementation must be objective, consistent, and accurate because of the several influences of the assigned triage scoring on treatment and health outcomes.

scholarly journals An unusual cause of recurrent pediatric vomiting (an extraluminal pyloric duplication cystic): A case report

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Leen Jamel Doya ◽  
Naya Talal Hassan ◽  
Fareeda Wasfy Bijow ◽  
Hanin Ahmed Mansour ◽  
Sawsan Ahmad ◽  
...  
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Early Recognition ◽  
Outlet Obstruction ◽  
Abdominal Ultrasound ◽  
Duplication Cyst ◽  
Common Symptom ◽  
Surgical Emergencies ◽  
Recurrent Vomiting ◽  
Life Threatening ◽  
Tomography Scan

ABSTRACT Vomiting is a common symptom of a multitude of diseases in children. It is usually part of benign illness and can occur at any age. Recurrent vomiting can be a symptom of life-threatening medical or surgical emergencies. It can be rarely caused by an extraluminal pyloric duplication cyst. Early recognition is essential for preventing delays in management and potential complications. Here we report a case of an extraluminal pyloric duplication presenting as progressive gastric outlet obstruction cyst in a 14-month-old Syrian boy. The diagnosis was made through abdominal ultrasound, gastrointestinal endoscopy and abdominal computed tomography scan.

Surgical resection of locally recurrent cervical cancer: a single institutional 70 patient series

2004 ◽  
Vol 14 (5) ◽  
pp. 846-851 ◽  
Author(s):  
V. Moutardier ◽  
G. Houvenaeghel ◽  
M. Martino ◽  
B. Lelong ◽  
V. J. Bardou ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Local Control ◽  
Cancer Recurrence ◽  
Palliative Surgery ◽  
Morbidity Rate ◽  
Actuarial Survival ◽  
Recurrent Cervical Cancer ◽  
Actuarial Survival Rate ◽  
Life Threatening ◽  
Threatening Situation

Pelvic recurrence of cervical cancer is a life-threatening situation and only local control can provide hope for remission. The aim of this study was to evaluate the role of surgery in the treatment of cervical cancer recurrence. This retrospective study analyzed a series of 70 patients who underwent resection of cervix locoregional recurrence. Thirteen patients had palliative salvage surgery for pelvic complications. Twenty-nine resections were considered as curative. Fifty recurrences required pelvic exenterations. The hospital mortality rate was 9% and the morbidity rate was 44%. Overall 5-year actuarial survival rate was 23%. Survival was significantly higher: (a) after curative resection and (b) after centropelvic recurrence resection. Local control was obtained in 48% of the cases and 13 patients are alive with a median follow-up of 75 months. In conclusion, the results of this small and heterogen series seem to justify an attempt to resection for centropelvic recurrences whenever possible. Palliative surgery should be reserved to salvage therapy and highly selected patients.

scholarly journals Meningitis, spondylodiscitis, pneumonia and septic shock with Streptococcus pneumoniae in a previously healthy woman with isolated IgG2-, IgG3-, IgA-deficiency and monoclonal gammopathy of undetermined significance

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Shahin Gaini ◽  
David Gudnason ◽  
Bjarni á Steig ◽  
Jenny Jónsdóttir Nielsen
Keyword(s):  
Septic Shock ◽  
Monoclonal Gammopathy ◽  
Left Lung ◽  
Healthy Woman ◽  
Caucasian Woman ◽  
Vaccine Response ◽  
Pneumococcal Infections ◽  
Prophylactic Measures ◽  
Life Threatening ◽  
Undetermined Significance

A 66 years old Caucasian woman with pneumococcal meningitis was treated and discharged after an uncomplicated course. Five months later she was readmitted withfever and right side abdominal pain and diagnosed with pneumococcal spondylodiscitis. One year later she was treated fora severe chest X-ray confirmed left lobar pneumonia. Two years later she was diagnosed with a pneumococcal pneumonia inher left lung with septic shock. An immunedeficiency screen revealed slightly reduced IgA levels, low IgG2 levels, low IgG3 levels and high IgG1 levels. No other immunedefects were identified. She did not respondserologically on vaccination with 13-valentconjugate and 23-valent polysaccharide pneumococcal vaccines. Further evaluations revealed a positive M-component inher blood and a bone marrow biopsy diagnosed her to have monoclonal gammopathy of undetermined significance. To protecther against future life threatening pneumococcal infections she was started on treatment with intravenous immunoglobulin. The case report illustrates the importance of thorough evaluation of patients with unusual infectious disease entities or unusual frequency of infections in individual patients. To optimize prophylactic measures and active treatment options in the individual patient, it is important to identify underlying causes of diseases and immune deficiencies that potentially can lead to life threatening infections. This is illustrated inour case by an undiagnosed monoclonal gammopathy of undetermined significancein an apparently healthy woman with atleast three life threatening documented pneumococcal infections in a two-year period and poor pneumococcal vaccine response

scholarly journals Necrotizing fasciitis with group A Streptococci and Eggerthella lenta as a complication of Varicella in a child – case presentation –

2014 ◽  
Vol 20 (1) ◽  
pp. 35-39
Author(s):  
Cambrea Simona Claudia ◽  
Ilie Maria Margareta ◽  
Carp Dalia Sorina ◽  
Ionescu C.
Keyword(s):  
Necrotizing Fasciitis ◽  
Severe Disease ◽  
The Body ◽  
Group A Streptococci ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
The Right ◽  
Surgery Department ◽  
Short Time

ABSTRACT Necrotizing fasciitis is a life threatening condition that can be quickly spread through the flesh surrounding the muscle. The disease can be polymicrobial, or caused by group A beta hemolytic Streptococci, or by Clostridium spp. We present a case of a 7 years old girl, which was hospitalized in Children Infectious Diseases Department in a 7th day of chickenpox (hematic crusts all over the body), high fever, asthenia, vomiting, oligoanuria, and tumefaction, pain and functio lessa in the right thigh. In a very short time in the right thigh swelling, edema and congestion have increased gradually, and in the third highest middle thigh the ecchymotic areas appeared evolving towards bubbles and blisters which included the right thigh and calf. After excluding the diagnosis of thrombophlebitis was raised suspicion of necrotizing fasciitis. CT pelvic scan evidenced pelvic asymmetry by maximus and medium right gluteal muscles swelling with important inflammatory infiltrate extended laterally in the subcutaneous adipose tissue. In blood culture was isolated Eggerthella lenta, and from throat swab was isolated group A Streptococci. Treatment consists of a combination of antibiotics associated with intravenous immunoglobulin administration. Despite medical treatment evolution worsened and required transfer in a pediatric surgery department where emergent surgical debridement associated with intensive antibiotic therapy was done. After this intervention evolution was slowly favorable without major limb dysfunction. Polymicrobial necrotizing fasciitis is a severe disease, which if recognized early can have a favorable outcome.

scholarly journals Prise En Charge Des Péritonites Aiguës Dans Un Hôpital De District En Afrique Sub-saharienne : Cas Du Bénin

2017 ◽  
Vol 13 (36) ◽  
pp. 388
Author(s):  
Bio Tamou Sambo ◽  
Salako Alexandre Allodé ◽  
Didier Sewadé Wekpon ◽  
Djifid Morel Séto ◽  
Montcho Adrien Hodonou ◽  
...  
Keyword(s):  
Mortality Rate ◽  
District Hospital ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Prise En Charge ◽  
Prospective Data ◽  
Acute Peritonitis ◽  
Generalized Peritonitis ◽  
Sub Saharan ◽  
Surgery Department

Introduction: Peritonitis remains a public health problem in Africa. We aim to describe the epidemiological, etiological and therapeutic aspects of acute peritonitis in a district hospital in Sub Saharan Africa. Methods: This was a descriptive study with prospective data collection over a period of 15 months from May 1 st 2015 to July 31st 2016 in Bembereke district hospital. It has taken into account all the patients managed in the general surgery department for acute generalized peritonitis that has been confirmed at laparotomy. Results: Fifty-three patients, 38 men (71.7 %) and 15 women (28.3 %) had been registered. The average age of the patients was 19.8 ± 16.9 years. The main etiologies were: non-traumatic ileal perforation from typhoid infection 52.8%; perforated gastric or duodenal ulcer 17%; complicated appendicitis and abdominal traumas 11.3% each one. Twenty nine patients (54.7%) have been operated by a surgeon and the 24 remaining (45.3%) by a general practitioner with surgical skills. Twenty one patients (39.6%) had postoperative complications of which 11 cases of parietal suppurations (52.4%). The mortality rate was 11.3%. The mean hospital stay was 22.5 ± 4 days. Conclusion: In northern-Benin, peritonitis remains dominated by the complications of typhoid fever. The mortality rate remains high. Prevention requires good hygiene and awareness of early consultations.

scholarly journals Bowel infarct with mucormycosis of the intestine

2019 ◽  
Vol 6 (7) ◽  
pp. 2609 ◽  
Author(s):  
Bharat Sangal ◽  
Rajeev Sharma ◽  
Molly Joseph ◽  
Debarghya Chatterjee
Keyword(s):  
Septic Shock ◽  
Fungal Infection ◽  
Male Patient ◽  
Adult Male ◽  
Bowel Infarction ◽  
Life Threatening ◽  
Cerebral Infection ◽  
Adult Male Patient

Gastrointestinal mucormycosis is a relatively uncommon opportunistic fungal infection. The classical presentation is that of a rhino-cerebral infection. It is a life threatening, angio-invasive condition typically affecting immunocompromised individuals. Only a handful cases of intestinal mucormycosis have been reported to date. Here, we discuss our experience regarding an adult male patient who succumbed to bowel infarction and perforation with septic shock due to intestinal mucormycosis.

scholarly journals P034 STRANGULATED DIAPHRAGMATIC HERNIA: TEN CASES REPORTS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Mehmet Gunay ◽  
gorkem uzunyolcu ◽  
yalın iscan ◽  
kaan gok ◽  
hakan yanar ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Diaphragmatic Hernia ◽  
Emergency Surgery ◽  
Penetrating Trauma ◽  
Abdominal Symptoms ◽  
Threatening Condition ◽  
Segmental Bowel Resection ◽  
Life Threatening ◽  
Surgery Department ◽  
Laparoscopic Techniques

Abstract Aim A diaphragmatic hernia (DH) is a protrusion of abdominal contents into the thoracic cavity as a result of a defect within diaphragm. It is most common as a congenital phenomenon; however, there have also been cases where it can be acquired. DH can be life-threatening, resulting in incarceration and strangulation. Material and Methods From June 2009 to April 2021, ten cases of strangulated diaphragmatic hernia were admitted to our Emergency Surgery Department of General Surgery with respiratory and abdominal symptoms. Patients' characteristics, operation details, and postoperative complications were retrospectively analyzed. Results There were 5 (50%) men and 5 (50%) women with a mean age of 66 years (range, 20–85 years). . Emergency surgery was performed by laparoscopic in 4(40%) patients and open in 6(60%) patients. Two patients had a history of penetrating trauma to the left thoracoabdominal region. Segmental bowel resection was performed in 3 patients and total gastrectomy in 1 patient. Reconstruction was not performed in the patient who underwent total gastrectomy due to ischemia and perforation. In the postoperative period, wound infection was observed in 2 patients. Anastomotic leakage was observed in 1 patient and treated with end enterostomy. Empyema was observed in one patient after discharge, the empyema was evacuated and thoracoscopic decortication was performed .The patient who underwent total gastrectomy died due to septic shock and comorbid diseases. Conclusions Strangulated diaphragmatic hernia is a life-threatening condition and requires emergency surgery. Laparoscopic techniques can also be used in treatment.

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