scholarly journals STUDY IN PAEDIATRIC AGE GROUP UNDERGOING EMERGENCY LAPAROTOMY : OBSERVATIONAL STUDY

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.

Clinical study of surgical management of acute intestinal obstruction in the adults

2021 ◽  
Vol 19 (1) ◽  
pp. 18-21
Author(s):  
Amit Girme ◽  
Keyword(s):  
Intestinal Obstruction ◽  
Surgical Management ◽  
Tertiary Care ◽  
Abdominal Distension ◽  
Acute Intestinal Obstruction ◽  
Emergency Laparotomy ◽  
Care Hospital ◽  
Age Group ◽  
Female Ratio ◽  
Male Predominance

Background: Acute Intestinal obstruction is defined as an obstruction in forwarding propulsion of the contents due to mechanical or neurological causes. Present study was aimed to evaluate the etiology, clinical presentation, surgical management and outcomes in patients with acute intestinal obstruction at our tertiary care hospital. Material and Methods: Present study was retrospective study conducted in patients >18 years age, diagnosed as case of intestinal obstruction, underwent emergency laparotomy for acute intestinal obstruction. Results: In present study, total 92 cases were studied. male predominance (72.83 %) was noted and male to female ratio was 2.68:1. Most common age group was between 41- 50 years (26.09%) followed by 51-60 years (20.65%) and 61-70 years (16.3%) age group. In present study most common sign and symptoms were abdominal tenderness (89.13 %), abdominal pain (85.87 %), vomiting (83.7 %), abdominal distension (75 %) and constipation (60.87 %). In present study most common etiology noted was adhesive obstruction (41.3 %), obstructed inguinal hernia (27.17 %), incisional hernia (9.78 %) and sigmoid volvulus (6.52 %). Other less common causes were ileocecal tuberculosis (3.26 %), ascending and descending colon growth (3.26 %), rectum/anal canal growth (3.26 %), sigmoid colon growth (2.17 %), internal hernia (2.17 %) and intussusception (1.09 %). Adhesiolysis + Resection Anastomosis (44.57 %) was most common surgical procedure followed by herniorrhaphy (36.96 %) and resection anastomosis (15.22 %). Sepsis (15.22 %), urinary tract infection (13.04 %), wound infection (11.96 %), basal atelectasis (6.52 %) and burst abdomen (6.52 %) were common complications noted in post-operative period. In present study 9.72% mortality was noted. Conclusion: Success in the treatment of acute bowel obstruction depends mainly on the early diagnosis and efficient management and treating the pathological effects of the obstruction as much as the treatment of the cause itself.

scholarly journals Trichobezoars: a hairy cause of intestinal obstruction

2020 ◽  
Vol 7 (5) ◽  
pp. 1658
Author(s):  
Anurag Tiwary ◽  
Pragati Singhal ◽  
Nida Khan ◽  
Pramod Tiwary
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Age Group ◽  
Rapunzel Syndrome ◽  
Surgical Exploration ◽  
Paediatric Age

Trichobezoars are an infrequent form of bezoar found in the stomach or intestine, created from ingested hair. Their most frequent location is in the stomach but they may extend through the pylorus into the small bowel. This condition is known as Rapunzel syndrome. Trichobezoar with Rapunzel syndrome is an uncommon diagnosis in children. Authors report 3 cases of Rapunzel syndrome with a large bezoar in paediatric age group that presented with features of acute intestinal obstruction. They were managed with surgical exploration.

A RARE CASE OF HETEROTOPIC PANCREATIC TISSUE CAUSING SMALL BOWEL OBSTRUCTION

2021 ◽  
pp. 4-5
Author(s):  
B. Santhi ◽  
M. Annapoorani ◽  
Sharada bhavana
Keyword(s):  
Intestinal Obstruction ◽  
Rare Case ◽  
Histopathological Examination ◽  
Pancreatic Tissue ◽  
Acute Intestinal Obstruction ◽  
Emergency Laparotomy ◽  
Review Of Literature ◽  
Heterotopic Pancreatic Tissue ◽  
Small Growth ◽  
Upper Gastrointestinal

A Rare case of heterotopic pancreatic tissue of ileum causing acute intestinal obstruction has been described with a brief review of literature. A 42 yr old male patient presented to the emergency department with features of acute intestinal obstruction. After evaluation patient was taken up for emergency laparotomy which revealed a band to be arising from ileum. Furthermore, there was a small growth in the ileal wall at the site of origin of the band. Hence resection of the growth was done and followed by ileoileal anastomosis. Later on, histopathological examination of the growth revealed it to be heterotopic pancreatic tissue. Heterotopic pancreatic tissue is often an incidental nding encountered in upper gastrointestinal tract during endoscopy and surgeries. But Symptomatic ectopic pancreas of ileum is relatively rare and they very rarely present with acute symptoms as in this case

Clinicoepidemiology and treatment outcome of acute intestinal obstruction in adult in KIMS Amalapuram: a retrospective observational study

2020 ◽  
Vol 7 (12) ◽  
pp. 4139
Author(s):  
Y. Anantha Lakshmi ◽  
K. V. Narasimha Reddy
Keyword(s):  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Age Group ◽  
Exclusion Criteria ◽  
Common Procedure ◽  
Case Record ◽  
Common Etiology ◽  
The Mean ◽  
Study Case ◽  
Surgical Admission

Background: The intestinal obstruction is a common potentially risky surgical emergency in all age group globally. This is responsible for 12% to 15% of surgical admission due to acute abdomen. Obstruction to gastrointestinal tract can occur at all labels but it is small intestine which more commonly involved. To improve the outcome early diagnosis and management is essential. Present study has been designed to study the epidemiology, demography and clinical presentation of acute intestinal obstruction and to study the complications and outcome of surgical management of acute intestinal obstruction.Methods: In present study patients admitted with diagnosis of acute intestinal obstruction during study period were enrolled for this study as per inclusion and exclusion criteria. As per that 126 patients were enrolled for this study. Case record of all patients were closely reviewed and analysed thoroughly.Results: The mean age of the patients was 54.64±12.93 years. The acute intestinal obstruction was more common in 41 to 60 years of age group that is (44.45%). Regarding etiology of acute intestinal obstruction 44.45% patient adhesion was the etiology of obstruction. Resection of adhesion was most common procedure done for removal of obstruction (42.85%).Conclusions: Adhesion was most common etiology and pain abdomen and tachycardia was common presentation. Regarding management of obstruction resection of adhesion was most common procedure done for removal of obstruction. Infection of wound was common complication.

scholarly journals Diagnostic accuracy of ultrasound in common acute abdominal conditions

2019 ◽  
Vol 6 (12) ◽  
pp. 4460
Author(s):  
Shashank Deshmukh ◽  
A. Manmadha Kishan
Keyword(s):  
Acute Pancreatitis ◽  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Diagnostic Accuracy ◽  
Acute Intestinal Obstruction ◽  
Ct Findings ◽  
Perforation Peritonitis ◽  
Good For ◽  
Operative Findings ◽  
Acute Perforation

Background: Ultrasound evaluation is cheap, easily available, even at rural level, and can predict need for surgical intervention in majority of conditions. It involves no exposure to radiation, can diagnose easily, can be repeated any number of times for follow up. Disadvantages are that it is user dependent and distended bowel containing air prevents satisfactory evaluation of abdomen. The objective was to study diagnostic accuracy of ultrasound in common acute abdominal conditions.Methods: All patients presenting to the emergency Department of General Surgery, Narayana general hospital, Nellore with abdominal pain of acute onset and who were diagnosed to be suffering from acute appendicitis, acute perforation peritonitis, acute intestinal obstruction, acute pancreatitis, acute calculous cholecystitis were included in the present study.Results: Diagnostic accuracy of USG for acute appendicitis was little bit low with sensitivity of 71.8% and specificity of 59.1% for operative findings and similar for CT findings. For acute perforation peritonitis it was still very low with sensitivity of 42.9% and specificity of 66.7% for operative findings and similar for CT findings. It was very good for acute intestinal obstruction with sensitivity of 90.9% and specificity of 83.3%, but here it was low compared to CT findings. It was also pretty good for diagnosing acute calculus cholecystitis in comparison with operative as well as CT findings.Conclusions: USG can be used as a diagnostic tool for diagnosis of acute intestinal obstruction and acute calculus cholecystitis but doubtful role in the diagnosis of acute appendicitis and acute perforation peritonitis and acute pancreatitis. 

scholarly journals Proportion of colonic carcinoma in cases presenting with acute intestinal obstruction: a cross sectional study

2021 ◽  
Vol 9 (1) ◽  
pp. 81
Author(s):  
Pauly T. Joseph ◽  
Rajiv Sajan Thomas ◽  
Sutharjivel V.
Keyword(s):  
Colon Cancer ◽  
Intestinal Obstruction ◽  
Dietary Habits ◽  
Colonic Neoplasms ◽  
Acute Intestinal Obstruction ◽  
Colonic Carcinoma ◽  
General Surgeon ◽  
Routine Practice ◽  
Common Cause ◽  
Obstructed Hernia

Background: Acute intestinal obstruction is one of the most common emergencies encountered by the general surgeon in routine practice. Although historically, obstructed hernia has been the most common cause, recent studies have shown that adhesive intestinal obstruction is now the commonest reason. Malignant bowel obstruction is also on the rise especially with the change in dietary habits. This study aims at identifying the proportion of colonic carcinoma in cases presenting with acute intestinal obstruction.Methods: The patients with acute intestinal obstruction which was diagnosed clinically and radiologically were studied. Based on operative and clinical findings along with investigation results, the etiology was identified. The patients having colonic neoplasms were identified and the data was compared with other etiological factors to find out the proportion of colonic carcinoma in the cases.Results: The proportion of colon cancer in patients presenting with acute intestinal obstruction was around 15%. The most common cause was obstructed hernia followed by post-operative adhesions. Males were more commonly affected than females. Most of the cases underwent operative management. The most common age group affected was around 50-60 years.Conclusions: This study confirms that there is a definite rise in the number of cases of colon cancer presenting as acute intestinal obstruction. There is also a skewing of the age at presentation towards younger age groups. Small bowel obstructions were much more common mainly due to adhesions and obstructed herniae.  

scholarly journals A prospective study of intestinal obstruction in paediatric age group

2017 ◽  
Vol 4 (6) ◽  
pp. 1979
Author(s):  
Amul Bhedi ◽  
Miten Prajapati ◽  
Arnab Sarkar
Keyword(s):  
Intestinal Obstruction ◽  
Prospective Study ◽  
Hypertrophic Pyloric Stenosis ◽  
Age Groups ◽  
Total Mortality ◽  
Infants And Children ◽  
Age Group ◽  
Female Ratio ◽  
Paediatric Age ◽  
A Prospective Study

Background: Intestinal obstruction can occur at any age in the paediatric population1-4. Bowel obstruction in children differs from that in adults in terms of etiology, presentation and even the management. The aim of the study was to find out various etiologies, clinical features, outcome and mortality of paediatric age groups with intestinal obstruction and their relation to age and sex distribution.Methods: This is a prospective study of 50 cases of paediatric age group with signs and symptoms of intestinal obstruction which were admitted in Sir Sayajirao Gaekwad Hospital, Vadodara, India during period of December 2004 to November 2006. Surgical intervention was carried out where indicated otherwise patients were managed conservatively. Data was analysed in SPSS version 10 statistical software for percentage and frequencies.Results: Total 50 patients were included in the study. Among these 30 were males and 20 were females with M: F ratio of 3:2. Majority of them were 25 neonates of age group of 1-7 days (50%), followed by 7 infants of 1 months- 1 years (14%) and 18 children aged 1 years-12 years (36%).  Out of 50 patients, 41 (82%) patients had congenital causes in which 21(42%) patients had imperforate anus followed by Hirschprung’s disease in 8(16%), Meckel’s diverticulum in 6(12%), jejunal atresia in 4(8%), hypertrophic pyloric stenosis in 2 patients (4%) and 9(18%) patients had acquired causes in which intussusception was in 5(10%) patients, abdominal tuberculosis in 2(4%) and gangrenous appendix in 2(4%) patients. Total mortality was 6 out of 25 neonates and there were no mortality in infants and children groups.Conclusions: Majority of patients were neonates than infants and children with slight male preponderance with male: female ratio of 3:2. Congenital causes of intestinal obstruction were more common (82%) than the acquired causes (18%). Postoperative septicaemia was more common and overall mortality was exclusively in neonates.

scholarly journals A prospective study of cases of intestinal obstruction and role of conservative expectant management

2018 ◽  
Vol 5 (6) ◽  
pp. 2191 ◽  
Author(s):  
Yuktansh Pandey
Keyword(s):  
Intestinal Obstruction ◽  
Prospective Study ◽  
Conservative Management ◽  
Expectant Management ◽  
Abdominal Tuberculosis ◽  
Acute Intestinal Obstruction ◽  
Age Group ◽  
Abdominal Adhesions ◽  
Tract Infections ◽  
A Prospective Study

Background: Intestinal obstruction continues to be a common surgical emergency throughout the world and its management protocol has evolved over years.  In our study we aimed to provide a complete epidemiological description of intestinal obstruction in adult age group patients in a tertiary care hospital in Northern India.Methods: This is a prospective study of patients belonging to age group more than 12 years admitted in our unit with clinical features suggestive of intestinal obstruction from September 2011 to December 2013 at R. N. T. Medical College, Udaipur. The study comprised of 134 patients.Results: Intestinal obstruction contributed to 6.5% of all surgical admissions. It was nearly twice more common in males. 43% patients presented with features of acute intestinal obstruction in comparison to 57% who presented with features of sub-acute intestinal obstruction. Most common cause observed was obstruction due to intra-abdominal adhesions followed by abdominal tuberculosis 48 and 29 percent respectively. Features of intestinal obstruction resolved in 60% patients with conservative management. Adhesions, abdominal tuberculosis and malignancy counted for majority of patients with sub-acute obstruction.  Emergency surgery was done in 32% of patients and 36.5 % of patients were discharged non-operatively. Planned Surgery after successful expectant management was done in 24 % patients. Most frequently seen complication was wound site collection (72.5%) followed by respiratory tract infections (49%). Total mortality in our study was 12.6% of which 41% was post-operative mortality and 59% mortality seen in patients who expired during conservative management.    Conclusions: This study demonstrates that intra-abdominal adhesions and abdominal tuberculosis account for most cases of intestinal obstruction in countries like India. A watchful expectant management can be tried in patients with prior operative history and those with history of tuberculosis.

scholarly journals An Audit on Gastrointestinal Perforation in a Tertiary Care Teaching Hospital Based in Northern Part of India: A Study of 100 Cases

2022 ◽  
Vol 8 (1) ◽  
pp. 106-116
Author(s):  
Rakesh Kumar Chanania ◽  
Lakshay Goyal ◽  
Sanjeev Gupta ◽  
Gagandeep Chanania ◽  
Sahil Heer
Keyword(s):  
Peptic Ulcer ◽  
Wound Infection ◽  
Primary Closure ◽  
Economic Status ◽  
Small Sample ◽  
Patch Repair ◽  
Age Group ◽  
Common Cause ◽  
Socio Economic Status ◽  
Perforation Peritonitis

Background: A prospective study was conducted on 100 patients of perforation peritonitis: To find out the incidence of gastro intestinal perforation in various age groups, sex, riral or urban, socio economic status, To find out the various causes and sites of gastra intestinal perforartions, To determine various types of procedures being done to treat gastro intestinal perforations.Methods:The study population consisted of 100 patients of perforation peritonitis admitted at surgical wards of Rajindra Hospital, Patiala. Patients underwent necessary investigations such as Blood counts, biochemical analysis and urine analysis. X-ray Abdomen and chest / USG Abdomen/Pelvis CT-Abdomen (as and when required). All diagnosed patients were subjected to surgery. In all cases, operative findings and postoperative course were followed up for three months. Final outcome was evaluated on the basis of clinical, operative and radiological findings. In pre-pyloric and duodenal perforation, GRAHAM’S PATCH REPAIR carried out. In Ileal and Jejunal perforations, primary closure or exteriorization done depending upon the condition of the gut and duration of the symptoms. The patient outcome was assessed by duration of hospital stay, wound infection, wound dehiscence, leakage/entero-cutaneous fistula, intra-abdominal collection/abscess, ileostomy related complications and reoperation. Wound infection was graded as per SSI grading.Results:Most common age group for perforation was 21-40 years (50%) followed by 41-60 (33%) years in present study. Mean age of the patients is 37.91 + 13.15 years with male predominance (78%) in our study. 4% of the patients were of upper socio-economic status while 32% of the patients were of middle and 64% of the patients were of lower socio-economic status.Abdominal pain was seen in 100% of the patients while abdominal distension was present in 69% of the patients. Nausea/Vomiting was seen in 61% of the patients while Fever and Constipation was seen in 53% and 86% of the patients respectively. Diarrhoea was seen in 3% of the patients. Tenderness, guarding & rigidity, distension, obliteration of liver dullness and evidence of free fluid were present in 100% of the patients. Bowel sounds were not detected in all the patients. Most common perforations were Duodena(37%), Ileal (25%), Gastric (25%) followed by Appendicular (9%), Jejunal (4%) and Colonic perforation (2%). The most common etiology of gastrointestinal perforations was Peptic ulcer followed by Typhoid, Appendicitis, Tuberculosis, Trauma, Malignancy and non-specific infection.In Gastric perforations, Peptic ulcer was the most common cause of perforation followed by Trauma. In Ileal perforations, Typhoid was the most common cause of perforation followed by Tuberculosis and non-specific infection. In Appendicular perforations, most common cause was Appendicitis. In Jejunal perforations, most common cause was Trauma. In Colonic perforations, most common cause was Malignancy.Conclusions:The incidence of gastrointestinal perforations was common in 21-40 years age group followed by 41-60 years age group with male preponderance in our study. The most common site of perforations was Gastro-duodenal followed by Ileal perforations and the most common cause for these perforations was peptic ulcer followed by typhoid. The most common procedure done to treat gastrointestinal perforations was primary closure, resection and anastomosis, appendectomy and stoma formation. However, small sample size and short follow up period were the limitations of the present study.

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