To Observe the Treatment Outcomes of Duodenal Injury in Penetrating and Blunt Trauma Patients

2021 ◽  
Vol 15 (10) ◽  
pp. 2715-2717
Author(s):  
Muhammad Asif ◽  
Muhammad Aamir Jamil ◽  
Imran Yousaf ◽  
Muhammad Faheem Anwer ◽  
Muhammad Waseem Anwar
Keyword(s):  
Hospital Stay ◽  
Blunt Trauma ◽  
Tube Thoracostomy ◽  
Clinical Aspects ◽  
Costal Margin ◽  
X Rays ◽  
Duodenal Injury ◽  
Adequate Treatment ◽  
Female Ratio ◽  
The Mean

Aim: To study about the management of duodenal injury in two clinical aspects, blunt and penetrating injury, along with its complications. Study design: Observational case series. Place and duration of study: Accident & Emergency and General Surgery Departments at M. Islam Teaching Hospital, Gujranwala from March 2019 to March 2020. Methodology: One hundred patients presenting in Accident & Emergency and General Surgical Department of with penetrating chest trauma as diagnosed clinically were included. Routine investigations like complete blood tests, X-rays and special investigations i.e. ultrasound, CT scan were done only in cases where patients were stable. Each hemithorax was divided into medial and lateral hemithorax by an imaginary line drawn longitudinally from clavicle down to the costal margin passing through the nipple. All patients were observed for the type of treatment they were getting i.e. thoracotomy or tube thoracostomy. Patients who were initially treated with tube thoracostomy were cautiously observed for any developing indications for thoracotomy. If such indications arose thoracotomy would be arranged at the earliest possible. Results: A total of 100 patients, 85 (85%) were males and 15 (15%) were females. Male to female ratio was 5.66:1. The mean age of patient was 35.65±9.75 years. There were 38 (38%) had road traffic accidents, 10 (10%) were fall, 7 (7%) injured with fight, 41 (41%) victims of firearm injury and only 4 (4%) victims of stab. The mean blood pressure was 82.15±7.97mmHg. Eighty five (85%) patients were stay in the hospital for 2 weeks and while 15 (15%) were hospital stay >2 weeks. The mean values of hospital stay was 12.45±4.16 days. Conclusion: It is concluded that penetrating thoracic trauma is a major cause of morbidity and mortality. The overall complications rate for blunt trauma injuries after adequate treatment is 18% and mortality rate is 8%. Keywords: Blunt trauma, Thorocotomy, Tube thoracostomy, Pneumothorax

scholarly journals Triple tubostomy and its outcome for blunt duodenal injury

2019 ◽  
Vol 22 (1) ◽  
pp. 12-17
Author(s):  
Narendra Pandit ◽  
Tek Narayan Yadav ◽  
Laligen Awale ◽  
Shailesh Adhikary
Keyword(s):  
Hospital Stay ◽  
Primary Closure ◽  
Early Stage ◽  
Primary Repair ◽  
Length Of Hospital Stay ◽  
Damage Control Surgery ◽  
Duodenal Fistula ◽  
Duodenal Injury ◽  
Female Ratio ◽  
The Mean

Introduction: Blunt duodenal injury in an uncommon form of abdominal injuries, which comprises less than 5% of all injuries. The diagnosis and management are challenging, because of delays in diagnosis due to subtle signs and symptoms in its early stage of presentation. Primary repair along with triple tubostomy (gastrostomy, retrograde duodenostomy and feeding jejunostomy) is a simple and safe method of damage control surgery in this group of patients. This study aims to report our experience in the management of this uncommon procedure. Methods: This is a retrospective analysis of the patients undergoing triple tubostomy (TT) for blunt duodenal injury at the Department of Surgery, B.P.Koirala Institute of Health Sciences (BPKIHS), Dharan, over a three and half years. The study included demographics, clinical profile, length of hospital stay, postoperative morbidity (duodenal fistula), rate and timing of spontaneous closure of fistula and mortality. Results: Eleven (6.7%) patients out of 164 blunt trauma abdomen had sustained a duodenal injury. Eight patients who underwent TT were included in the study. The mean age of the patient was 31.8 years (range: 18-67), with a male: female ratio of 3:1. The mean time to trauma and presentation was 4.25 days. The most common site of injury was the second part of the duodenum (87.5%), AAST grade III was seen in 62.5%, two (25%) patients were in shock at presentation. Eight patients required primary closure with triple tubostomy. Postoperatively, all patients had a duodenal fistula, which closed spontaneously in 6 (75%) patients at a mean duration of 17 days, with a mean postoperative length of hospital stay of 33.5 days. The remaining two (25%) patients died of an active fistula. Conclusion: Blunt duodenal trauma, when presented late can be managed with primary closure and triple tubostomy with acceptable postoperative outcomes.  

scholarly journals Effects of the COVID-19 Pandemic on the Epidemiology of Knee and Shoulder Arthroscopy

2021 ◽  
Vol 58 ◽  
pp. 004695802110560
Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Piotr Morasiewicz
Keyword(s):  
Hospital Stay ◽  
Shoulder Arthroscopy ◽  
Demographic Data ◽  
Epidemiological Data ◽  
University Hospital ◽  
Female Ratio ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Orthopedic Patients ◽  
Male To Female

The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopy performed in an orthopedic department of a university hospital in Poland. This study compared the data on all shoulder and knee arthroscopy procedures performed in two different periods: The period of the COVID-19 pandemic in Poland (from March 4, 2020, to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019, to October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration. The total number of arthroscopy procedures conducted in the evaluated period in 2020 was approximately 8.6% higher than that in the corresponding 2019 period. The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019. The male-to-female ratio was shown to be lower at .85 during the pandemic, having decreased from 1.5 in 2019. The COVID-19 pandemic did not reduce the number of arthroscopy performed at our center, and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.

scholarly journals Diagnostic and Clinical Management of Skull Fractures in Children

2016 ◽  
Vol 6 ◽  
pp. 47
Author(s):  
Christoph Arneitz ◽  
Maria Sinzig ◽  
Günter Fasching
Keyword(s):  
Hospital Stay ◽  
Head Trauma ◽  
Clinical Management ◽  
Skull Fracture ◽  
Neurological Symptoms ◽  
Ct Scans ◽  
Skull Fractures ◽  
X Rays ◽  
Minor Head Trauma ◽  
The Mean

Objective: The indications of routine skull X-rays after mild head trauma are still in discussion, and the clinical management of a child with a skull fracture remains controversial. The aim of our retrospective study was to evaluate our diagnostic and clinical management of children with skull fractures following minor head trauma. Methods: We worked up the medical history of all consecutive patients with a skull fracture treated in our hospital from January 2009 to October 2014 and investigated all skull X-rays in our hospital during this period. Results: In 5217 skull radiographies, 66 skull fractures (1.3%) were detected. The mean age of all our patients was 5.9 years (median age: 4.0 years); the mean age of patients with a diagnosed skull fracture was 2.3 years (median age: 0.8 years). A total of 1658 children (32%) were <2 years old. A typical boggy swelling was present in 61% of all skull fractures. The majority of injuries were caused by falls (77%). Nine patients (14%) required a computed tomography (CT) scan during their hospital stay due to neurological symptoms, and four patients had a brain magnetic resonance imaging. Nine patients (14%) showed an intracranial hemorrhage (ICH; mean age: 7.3 years); one patient had a neurosurgery because of a depressed skull fracture. Nine patients (14%) were observed at our pediatric intensive care unit for a mean time of 2.9 days. The mean hospital stay was 4.2 days. Conclusions: Our findings support previous evidence against the routine use of skull X-rays for evaluation of children with minor head injury. The rate of diagnosed skull fractures in radiographs following minor head trauma is low, and additional CT scans are not indicated in asymptomatic patient with a linear skull fracture. All detected ICHs could be treated conservatively. Children under the age of 2 years have the highest risk of skull fractures after minor head trauma, but do not have a higher incidence of intracranial bleeding. Neuroobservation without initial CT scans is safe in infants and children following minor head trauma and CT scans should be reserved for patients with neurological symptoms.

scholarly journals Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Uzung Yoon ◽  
Jeffrey Mojica ◽  
Matthew Wiltshire ◽  
Kara Segna ◽  
Michael Block ◽  
...  
Keyword(s):  
High Risk ◽  
Hospital Mortality ◽  
Airway Management ◽  
Hospital Stay ◽  
Operating Room ◽  
X Rays ◽  
Icu Stay ◽  
Management Interventions ◽  
The Mean ◽  
Emergent Airway Management

Abstract Background Emergent airway management outside of the operating room is a high-risk procedure. Limited data exists about the indication and physiologic state of the patient at the time of intubation, the location in which it occurs, or patient outcomes afterward. Methods We retrospectively collected data on all emergent airway management interventions performed outside of the operating room over a 6-month period. Documentation included intubation performance, and intubation related complications and mortality. Additional information including demographics, ASA-classification, comorbidities, hospital-stay, ICU-stay, and 30-day in-hospital mortality was obtained. Results 336 intubations were performed in 275 patients during the six-month period. The majority of intubations (n = 196, 58%) occurred in an ICU setting, and the rest 140 (42%) occurred on a normal floor or in a remote location. The mean admission ASA status was 3.6 ± 0.5, age 60 ± 16 years, and BMI 30 ± 9 kg/m2. Chest X-rays performed immediately after intubation showed main stem intubation in 3.3% (n = 9). Two immediate (within 20 min after intubation) intubation related cardiac arrest/mortality events were identified. The 30-day in-hospital mortality was 31.6% (n = 87), the overall in-hospital mortality was 37.1% (n = 102), the mean hospital stay was 22 ± 20 days, and the mean ICU-stay was 14 days (13.9 ± 0.9, CI 12.1–15.8) with a 7.3% ICU-readmission rate. Conclusion Patients requiring emergent airway management are a high-risk patient population with multiple comorbidities and high ASA scores on admission. Only a small number of intubation-related complications were reported but ICU length of stay was high.

scholarly journals Transurethral fragmentation of bladder stone in children: Our experience

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Ghulam Mujtaba Zafar ◽  
Naseem Javed ◽  
Fawad Humayun ◽  
Asif Iqbal
Keyword(s):  
Hospital Stay ◽  
Operating Time ◽  
Bladder Stone ◽  
Average Hospital ◽  
Female Ratio ◽  
Bladder Stones ◽  
Stone Recurrence ◽  
Febrile Uti ◽  
The Mean ◽  
One Year

Background: This study is performed to find the outcome of transurethral fragmentation and clearance of bladder stones in children as well as assessment of stone recurrence after the procedure. Methods: It was a retrospective analysis of the medical record of 365 patients with bladder stones, treated with transurethral fragmentation at the Department of Pediatric Urology, The Children’s Hospital and the Institute of Child Health, Lahore, over a period of 5 years. Bladder stones were fragmented by using ureterorenoscope (URS) and pneumatic Lithotripsy under general anesthesia. Patients were asked to void next day for spontaneous passage of stone fragments. Duration of procedure, hospital stay, peroperative, and postoperative complications were recorded on a self-structured proforma. The collected data was analyzed with SPSS, version 22. Results: The mean age of the patients was 4.7 ±2.31 years, and male to female ratio was 6:1. Clinical presentation was painful micturition with milking of penis (55%), followed by straining during micturition (17.5%), urinary retention (10%), increased frequency of urine (8%), febrile UTI (7.5%), and hematuria (2%). The mean stone size on ultrasound was 17.2 ±3.8 mm (Range 7-25 mm). The average operating time was 18 minutes (Range: 12-35 minutes). The transurethral fragmentation was successfully done in all (100%) patients. Average hospital stay was 24 hours. Most patients (98.5%) passed all stone fragments in urine & were stone free at one week, confirmed by ultrasound and X-Ray Kidney, Ureter, and Bladder (KUB). Postoperative minor complications were found in (6%) patients including hematuria (3%), dysuria (2%), febrile UTI (1%), failure to void (0.5%). Stone recurrence was 0.27% and no urethral stricture was noted up to one year follow up. Conclusion: Endoscopic treatment of bladder stone in children appears effective and safe by fragmenting the stone into multiple small pieces, which passed out spontaneously without any need for extraction of stone. The associated complications and recurrence rate are very negligible.

scholarly journals LOWER URETERIC STONES EXPULSION;

2017 ◽  
Vol 24 (09) ◽  
pp. 1331-1335
Author(s):  
Khalid Hussain ◽  
Maria Tarique ◽  
Attiq ur Rehman Khan ◽  
Asim Bukhari ◽  
Bilal Akhter ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Oral Treatment ◽  
P Value ◽  
X Rays ◽  
Female Ratio ◽  
Group A ◽  
Insignificant Difference ◽  
The Mean ◽  
Group B ◽  
Trial Setting

Objectives: To compare Tamsulosin versus ESWL for lower ureteric stonesexpulsion. Study Design: Randomized controlled trial. Setting: Outpatient Department ofUrology at Services Hospital, Lahore. Period: January 2015 to December 2015. Material& Methods: Total 50 patients were enrolled in study. Patients were divided into 2 groups.In group A, 25 patients received daily oral treatment of 0.4mg Tamsulosin for 28 days, andin group B, 25 patients were treated with ESWL. A stone-free condition, was defined as thecomplete absence of any stone based on plain abdominal X-rays observed and during followupvisits at the time of treatment of stone was noted. Results: The mean age of the patientswere recorded as 33.20±9.23 years. There were 40(80%) males and 10(20%) females with maleto female ratio of 4:1. Out of 50 patients, 16(32%) presented with hematuria, 3(6%) had feverwhile 31(62%) appeared with no complication status. Out of 50 patients, 21(42%) presentedwith expulsion time 08-14 days in which 14(28%) were from tamsulosin group and 07(14%)were from ESWL group, similarly 19(38%) patients appeared with expulsion time of 15-28 daysin which 10(20%) were from tamsulosin group and 09(18%) were from ESWL group. Statisticallythere is insignificant difference between the groups i.e. p-value=0.28 Ns. Conclusion: Thisstudy suggests that the tamsulosin helps in the earlier clearance of stone fragments andreduces the complications as compared to ESWL.

scholarly journals Cystic Echinococcosis of the Bone in Kazakhstan

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Tommaso Manciulli ◽  
Aigerim Mustapayeva ◽  
Konrad Juszkiewicz ◽  
Ekaterina Sokolenko ◽  
Zhaksylik Maulenov ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Cystic Echinococcosis ◽  
Malignant Tumors ◽  
Long Bones ◽  
Female Ratio ◽  
X Ray ◽  
Male Female Ratio ◽  
The Mean

Cystic echinococcosis (CE) is a parasitic zoonosis caused by E. granulosus primarily affecting the liver and lungs. CE of the bone is by far the most debilitating form of the disease and is very difficult to manage as it mimics malignant tumors. We reviewed bone CE cases admitted to a reference oncological hospital in Kazakhstan from January 2010 to February 2017. Among eight patients, the mean age was 33.5 years, and the male/female ratio was 1 : 3. Patients were examined by X-ray (8/8), CT (7/8), and MRI (3/8). CE was in the spine (2 cases), pelvis (3 cases), and long bones (humerus, tibia, and femur; one case for each). All patients were treated surgically. No perioperative albendazole was administered. No patient received albendazole afterwards. The mean hospital stay was 25 days. Interventions are urgently needed to assess the burden of CE in Kazakhstan and to inform clinicians of the existence of the disease.

scholarly journals LAP STAPLER GASTROJEJUNOSTOMY WITH TOTAL TRUNCAL VAGOTOMY FOR BENIGN GASTRIC OUTLET OBSTRUCTION.

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Sahun .
Keyword(s):  
Hospital Stay ◽  
Postoperative Complication ◽  
Operative Time ◽  
Outlet Obstruction ◽  
Length Of Hospital Stay ◽  
Truncal Vagotomy ◽  
Term Outcome ◽  
Female Ratio ◽  
Advantages And Disadvantages ◽  
The Mean

Aims: To study the advantages and disadvantages of laparoscopic truncal vagotomy and gastrojejunostomy, the outcome of surgery in terms of – mean operative time, Conversion rate, Postoperative pain measurement, intraoperative and postoperative complication and duration of hospital stay. Methods: A prospective analysis of operative, postoperative and short term outcome of 21 patients were carried out during time period of 2016 to 2019. Results: Out of 21 patient,.64% patients were males and 36 % patients were females. Male to female ratio was 1.7: 1. The mean operative time required was 130 minutes and the mean pain scale measured was 3 ± 0.81 on second day .The incidence of intraoperative and early postoperative complication was 5.26 % and 10.52 % respectively. The mean length of hospital stay was 8 days. Average follow up duration was 12 months. Conclusion: It is viable and safe option with shorter operative time and length of stay. It can be performed successfully with minimal morbidity and no mortality. However extreme care and skill is required to identify anatomy and handling of stapler. Keywords: Laparoscopy; Stapler Gastrojejunostomy; Vagotomy; Endoscopy.

scholarly journals Effects of the COVID-19 Pandemic on the Epidemiology of Knee and Shoulder Arthroscopy Procedures in a University Hospital Department in Poland

2021 ◽  
Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Piotr Morasiewicz
Keyword(s):  
Hospital Stay ◽  
Shoulder Arthroscopy ◽  
Demographic Data ◽  
Epidemiological Data ◽  
University Hospital ◽  
Female Ratio ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Orthopedic Patients ◽  
Male To Female

Abstract Background: The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopies performed in an orthopedic department of a university hospital in Poland.Methods: This study compared the data on shoulder and knee arthroscopy procedures performed in two different periods: the period of the COVID-19 pandemic in Poland (from March 4, 2020 to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019–October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration.Results: The total number of arthroscopy procedures conducted in the evaluated period in 2020was approximately 8.6% higher than that in the corresponding 2019 period.The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019.The male-to-female ratio was shown to be lower at 0.85 during the pandemic, having decreased from 1.5 in 2019Conclusions: The COVID-19 pandemic did not reduce the number of arthroscopies performed at our center and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.

The results and outcome of primary spontaneous pneumothorax in adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Servet Melike Akıncı ◽  
Tutku Soyer ◽  
Şule Yalçın ◽  
Saniye Ekinci ◽  
İbrahim Karnak ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Autologous Blood ◽  
Treatment Options ◽  
Surgical Excision ◽  
Acute Onset ◽  
Tube Thoracostomy ◽  
Primary Spontaneous Pneumothorax ◽  
Smoking History ◽  
Adequate Treatment ◽  
Female Ratio

AbstractAimPrimary spontaneous pneumothorax (PSP) is a rare pulmonary pathology that occurs in the absence of known lung disease. A retrospective study was performed to evaluate the results and outcome of PSP treatment in adolescents.MethodsThe cases with PSP from January 2004 to December 2017 were evaluated for age, sex, family and smoking history, clinical and radiological findings and results of treatment.ResultsTen cases with PSP were included. The mean age of the patients was 15 years (10–17 years) and the male to female ratio was 9:1. Two of the patients (20%) had family history of PSP and four cases (40%) had smoking history. The initial complaints were chest pain (n=8), acute onset of cough (n=1) and breathing difficulty (n=1). Tube thoracostomy was performed in nine cases in which three of them were bilateral. Chest computed tomography (CT) demonstrated bullae (n=4; 40%) and subpleural blebs (n=2; 20%). Pleurodesis with talc was performed in four patients with pneumothorax for longer than a week in follow-up (n=4; 40%). Five cases had recurrent PSP within one year (n=5; 50%) and underwent pleurodesis with talc (n=4), autologous-blood (n=1) and bleomycin (n=1). Bleb excision was performed in two cases with persistent pneumothorax despite pleurodesis.ConclusionTube thoracostomy and oxygen supplementation, are considered as initial and adequate treatment of PSP in most of the adolescents. Prolonged air leaks require pleurosdesis as the first line treatment and surgical excision of blebs should be reversed for the patients who are unresponsive to other treatment options.

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