A comparative study between right hemicolectomy with ileotransverse anastomosis and primary repair with or without ileostomy/Colostomy in the management of Caecal perforation

An 82-year-old man presented with abdominal pain and a painful and swollen left thigh. On examination there was oedema, tenderness and crepitus with skin discoloration of the left thigh. Computed tomography showed retroperitoneal perforation of the caecum and necrotising fasciitis of the left thigh. A right hemicolectomy and repeated fasciotomies of the left thigh with debridement of necrotic tissue were performed but the patient died of multi-organ failure. Histology showed a pT4aN2c caecal adenocarcinoma. This is a unique presentation of a retroperitoneal caecal perforation and acts as a reminder that unexplained severe fasciitis of the thigh may be caused by an intra-abdominal pathology.

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Caecal Perforation from Primary Intestinal Tuberculosis in Pregnancy

Case Reports in Gastrointestinal Medicine ◽

10.1155/2017/2173724 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Soe Lwin ◽

Nina Lau Lee Jing ◽

Haris Suharjono ◽

Mardiana binti Kipli ◽

Tin Moe Nwe ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Case Report ◽

Preterm Delivery ◽

Bowel Disease ◽

Intestinal Tuberculosis ◽

Right Hemicolectomy ◽

Migrant Communities ◽

Inflammatory Bowel ◽

Caecal Perforation ◽

In Pregnancy

The incidence of tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of extrapulmonary TB (EPTB) can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. We present a case of caecal TB in pregnancy, which resulted in caecal perforation, a right hemicolectomy, and severe preterm delivery. The aim of this case report is to discuss the diagnosis of extrapulmonary TB, as well as its subsequent management in pregnancy.

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A Comparative Study of Two Methods of Controlled Mobilization of Flexor Tendon Repairs in Zone 2

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(98)80216-7 ◽

1998 ◽

Vol 23 (1) ◽

pp. 41-45 ◽

Cited By ~ 73

Author(s):

F H. PECK ◽

C. A. BÜCHER ◽

J. S. WATSON ◽

A. ROE

Keyword(s):

Comparative Study ◽

Prospective Study ◽

Range Of Motion ◽

Flexor Tendon ◽

Primary Repair ◽

Tendon Injuries ◽

Matched Pairs ◽

Motion Group ◽

Active Motion ◽

Injury Characteristics

This prospective study compares subjects following primary repair of flexor tendons in zone 2 using either controlled active motion or a modified Kleinert regime. A matched pairs design was employed, subjects being matched for gender, age and injury characteristics. Twenty-six pairs of subjects with 92 tendon injuries in 52 digits were assessed 12 weeks postoperatively in respect of range of motion and dehiscence. Outcomes were defined using the Strickland criteria. No statistically significant differences in respect of range of motion were demonstrated between the groups. Incidence of rupture, however, was significantly less in the modified Kleinert group (7.7%) than in the controlled active motion group (46%).

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Open versus primary repair following hemorrhoidectomy for Grade III hemorrhoids: a prospective comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20184092 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3377

Author(s):

Abdul Ghader Barazandeh Moghadam ◽

Shoaibuddin Mohammad ◽

Bushra Khan

Keyword(s):

Statistical Analysis ◽

Comparative Study ◽

Return To Work ◽

Primary Repair ◽

Anal Stenosis ◽

P Value ◽

Duration Of Surgery ◽

Prospective Comparative Study ◽

Open Versus ◽

Grade Iii

Background: The debate on open versus primary closure following haemorrhoidectomy continues to be active. Despite other methods like doppler guided haemorrhoidal artery ligation, sclerotherapy, cryotherapy, banding; open haemorrhoidectomy is performed at many places. The never-ending discussion on the better choice between open versus primary repair led to the initiation of this work.Methods: This is a prospective comparative study of a contiguous and continuous cohort of 105 cases. Alternate cases were assigned for either of the procedures. Only grade III haemorrhoids were included. Grade I and II haemorrhoids, cases treated earlier and recurrent haemorrhoids were excluded. Multiple parameters like duration of surgery, intraoperative and post-operative bleeding, pain duration and severity, time taken to return to work, use of dressings and sitz bath, wound healing time and stenosis were studied. A blinded statistical analysis was done by a third-party statistician. Results: Primary haemorrhoidectomy took a significantly longer time (P value- 0.0043). Pain was significantly less with open haemorrhoidecomy (P value- 0.0023). Post-operative pain was significant in primary repair. Pain was assessed using visual analogue scale and verbal rating scale. Open haemorrhoidectomy took a significantly longer time to heal (P value: 0.0004) and return to work (P value: 0.0001). Primary repair had stenosis requiring dilatation in a few cases. Statistical analysis was done in all cases. Conclusions: Primary repair seems to be preferred because of shorter duration of recovery despite more pain and occasional anal stenosis.

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Carcinoma transvers colon with caecal perforation mimicking appendicular lump

Pulse ◽

10.3329/pulse.v3i1.6552 ◽

1970 ◽

Vol 3 (1) ◽

pp. 29-30

Author(s):

BC Das ◽

IM Khan ◽

Q Alam ◽

A Rahman

Keyword(s):

Small Bowel ◽

Transverse Colon ◽

Primary Anastomosis ◽

Iliac Fossa ◽

Lateral Wall ◽

Right Hemicolectomy ◽

Tissue Mass ◽

Fecal Matter ◽

Lateral Abdominal Wall ◽

Caecal Perforation

A 43 year-old female with caecal perforation and localized peritonitis as a result of transverse colon malignant stricture was presented. Initially she was evaluated in two different clinics and treated conservatively as appendicular lump. She was brought to Apollo Hospitals Dhaka as her condition deteriorated. CECT abdomen disclosed an annular soft tissue mass at mid part of transverse colon that completely obstructed the lumen. The colon proximal to the lesion and small bowel were grossly dilated and filled up with fecal matter. On laparotomy, a lump was noted in right iliac fossa which was made of omentum, small bowel and lateral abdominal wall. A perforation was noted in the lateral wall of caecum after dismantling the lump. The colon and the small bowel were decompressed through caecal perforation site peroperatively. Right hemicolectomy and primary anastomosis was performed. Patient survived the operation and she was discharged from hospital on the 10th postoperative day with an advice of regular follow up in surgical OPD. She was referred to Oncology centre for chemotherapy.In conclusion, any patient around the age of forty or above with features of appendicular lump deserves full work-up including CECT to exclude colonic malignancy. Resection and primary anastomosis may be a preferred procedure for right colonic carcinoma perforation.DOI: 10.3329/pulse.v3i1.6552Pulse Vol.3(1) July 2009 p29-30

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