scholarly journals A Prospective Study on Clinico-Radiological Correlation and Conservative Management of Non-Traumatic Acute Abdomen at a Tertiary Care Centre

2021 ◽  
pp. 119-124
Author(s):  
Rajat Mahawar ◽  
Suresh Chandak ◽  
Meenakshi Yeola
Keyword(s):  
Abdominal Pain ◽  
Acute Abdomen ◽  
Clinical Diagnosis ◽  
Conservative Management ◽  
Financial Burden ◽  
Tertiary Care ◽  
Fatal Outcome ◽  
Imaging Studies ◽  
Tertiary Care Centre ◽  
Clinical Presentations

Background: Acute abdomen is a condition in which the patient complains of a sudden or gradual attack of abdominal pain over a duration of several hours and presents with a set of symptoms which indicatea life threateningillness that needs an urgent or quick diagnosis for early treatment. Delay in diagnosis will worsen the condition of the patient and can even have a fatal outcome. It is crucial to recognize situations where laparotomy can be avoided in order to bring down morbidity and financial costs. Hence this study is being conducted to evaluate various clinical presentations, accuracy of clinical diagnosis, causes, better imaging studies and effectiveness of conservative management of non-traumatic acute abdomen. Objectives: To study various clinical presentation of non-traumatic acute abdomen. To study the accuracy of clinical diagnosis of non-traumatic acute abdomen To study different causes of acute abdomen. Compare different imaging studies in cases of acute abdomen and to evaluate their accuracy in diagnosing the condition. To study the effectiveness of conservative management (OchsnerScherren regimen) in cases of acute abdomen. Methods: The study will be doneat Dept. of General Surgery, J.N.M.C and AVBRH, Wardha. The duration of the study will be 2 years from September 2020 to August 2022. In this study, 80-100 Patients of acute abdomen attending the routine OPD and Emergency room at AVBR Hospital will be studied. Thorough clinical examination will be done and Patients with Abdominal pain will be categorized according to inclusion and exclusion criteria. Clinical findings with Radiological findings will be correlated and the sensitivity of imaging studies in diagnosing acute abdomen will be evaluated. The outcome of conservative management of non-traumatic acute abdomen will be observed. Results: We expectto study various clinical presentations of acute abdomen, causes, evaluate the accuracy of imaging studies and to study the effectiveness of conservative management all of which in turn would lead to early and better management of acute abdomen. Conclusion: Better understanding about presentation, causes, the accuracy of radiological studies and effectiveness of conservative management would help in identification of cases in which laparotomy can be avoided to prevent unnecessary surgery with its associated morbidity and financial burden.

scholarly journals Lower Genital Tract Trauma in a Tertiary Care Centre in Mid-Western Nepal

2017 ◽  
Vol 56 (205) ◽  
pp. 137-140
Author(s):  
Anil Kumar Adhikari ◽  
Mahuya Dutta ◽  
Chittra Ranjan Das
Keyword(s):  
Genital Tract ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Genital Tract ◽  
Clinical Presentations ◽  
Fall From Height

Introduction: The study of lower genital tract trauma has become important in gynaecological practice. There is paucity of reports on this clinical entity from our settings. The main aim of this study is to document injuries in female lower genital tract in Mid-Western Nepal. Methods: Sixty female patients admitted to the hospital with genital tract injuries caused by coitus or accidents were included in the study. Details of the causes of trauma clinical presentations and management were recorded. Results: These injuries were grouped according to etiological factors. This study included 33 (55%) coital injuries and 27 (45%) non- coital injuries. Out of coital injury, 12 cases were criminal assault (rape) in age group of 4 to 18 years. Four unmarried girls had consensual sex. Non-coital injuries were due to fall from height, cattle horn injuries, straddle type of trauma, vulvar haematoma and anorectal injuries. Conclusions: Appropriate surgical intervention can avert morbidity and mortality. Keywords: accident; lower genital tract; Nepal; trauma.

Clinical Profile of Polycystic Ovarian Syndrome Patients In Tertiary Care Hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 99-103
Author(s):  
Dr. Urmila Gavali ◽  
Dr. Mayuri Pawar ◽  
Dr. Gautam Aher ◽  
Dr. Suhas Shinde
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Genetic Disorder ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Clinical Presentations ◽  
Complex Genetic Disorder ◽  
Uncertain Etiology ◽  
Ovarian Syndrome

ABSTRACT: Background: Polycystic ovarian syndrome (PCOS)is common gynecological endocrinopathy characterized by chronic anovulation and hyperandrogenism affecting 5-10% of women worldwide.  It is a heterogenous, multifactorial, complex genetic disorder with uncertain etiology and is one of the most common treatable cause of infertility. AIM: To study the various clinical presentations in polycystic ovarian syndrome. MATERIALS AND METHODS: Present study is cross sectional observational study carried out in tertiary care centre. This study was performed in the Out Patient Department of Obstetrics and Gynecology. RESULTS: The mean age of 41 patients in the study was 23.6 years. Most common presenting symptom in patients is menstrual irregularities (89%) followed by infertility and hirsutism. USG (abdo+pelvis) showing polycystic ovarian syndrome ovaries. Around 39% patients with PCOS developed insulin resistance. KEYWORDS: - Amenorrhea, Infertility, Oligomenorrhea, Polycystic Ovarian Syndrome.

APPENDICITIS IN PREGNANCY : OUR CLINICAL EXPERIENCE AT A TERTIARY CARE CENTRE

2021 ◽  
pp. 22-23
Author(s):  
Anil Kumar ◽  
Rekha Rani ◽  
Hamid Wani
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Common Symptom ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Quadrant ◽  
Number Of Patients

Objective: Acute appendicitis is a common surgical condition presented to emergency. In this study we evaluated the clinical presentation, management and outcome of acute appendicitis complicating pregnancy at a tertiary care centre. Material And Methods: A total of 20 cases of pregnant women who were diagnosed as a case of acute appendicitis were studied from January 2018 to December 2020. Results: Total number of patients diagnosed with acute appendicitis were 20. There were 10 (50%) patients in rst trimester , 6 (30%) in second and 4 (20%) in the third trimester. Abdominal pain was the most common symptom seen in all patients. 12 (60%) patients were multigravida whereas 8 (40%) patients were primigravida. Duration of abdominal pain was 6 hours to 5 days with median of 30 hours. Right lower quadrant was the most common site of pain. Rebound tenderness was seen in 14 (70%) patients. Total leucocyte was raised in 14 (70%)cases. Ultrasound was done in all patients showing viable fetus and features of acute appendicitis in 12 (60%) cases. Surgery was done in 16 (80%) cases. Midline laparatomy was done in 3 patients whereas 4 (20%) patients were managed conservatively with antibiotics. Postoperative tocolytics were given in 6 patients. Postoperative complications such as wound infections seen in 5 cases and pelvic abscess in 1 case. Fetal loss was seen in 2 (10%)cases. Conclusion: Diagnosis of acute appendicitis during pregnancy can be difcult due to anatomical and biochemical changes during pregnancy. Correct diagnosis can be achieved by taking proper history, clinical examination and relevant investigations. Surgery remains the treatment of choice.

scholarly journals Postpartum intrauterine contraceptive device (PPIUCD) insertion: practices and aftermath at tertiary care centre

2018 ◽  
Vol 7 (11) ◽  
pp. 4742 ◽  
Author(s):  
Kanchan Rani ◽  
Nirmal Kumar Pangtey ◽  
Garima Khanna ◽  
Mahima Rani
Keyword(s):  
Abdominal Pain ◽  
Family Planning ◽  
Tertiary Care ◽  
Unmet Need ◽  
Lower Abdominal Pain ◽  
Postnatal Period ◽  
Technical Committee ◽  
Contraceptive Device ◽  
Tertiary Care Centre ◽  
Expulsion Rate

Background: According to USAID/ ACCESS 2009 survey, in India, 65% of women in first year postpartum have an unmet need for family planning. Recommended spacing between birth to next pregnancy is at least 24 months and between abortion to next pregnancy is at least six months (WHO Technical Committee,2006). Pregnancy before 24 months of previous birth increase maternal and perinatal morbidity and mortality. So, during this postnatal period woman must be offered any form of reversible contraceptive. IUCD is most frequently use reversible method of family planning in the world. The aim of present study is to evaluate acceptability safety efficacy and complication of PPIUCD in tertiary care center.Methods: This is a retrospective study conducted at Government Medical College and Hospital in northern India over a period of 1 year from January 2016 to December 2016. Patients were followed up to 6 months period and their complaints and various parameters were analyzed.Results: 219 patients were inserted PPIUCD during 1-year period. Acceptance rate was higher in P2 (51.6%), between 20 to 25 years of age (47.49%) followed by 26 – 30 years of age (38.8%). On follow up 44.3% had no complaints. Most common complaints were lower abdominal pain (15%), missing thread (14.6%) and vaginal discharge (8.2%). 5.48% women came for removal of IUCD. Main cause of removal was pressure from family and lower abdominal pain. Expulsion rate was low (2.74%). There was no case of perforation or failure (pregnancy).Conclusions: During present study authors found that PPIUCD is highly effective, acceptable, safe and with fewer side effects. PPIUCD is especially beneficial in Indian population where accessibility for contraception is lower during interval period and women do not come for contraception during postpartum period.

scholarly journals Outcome of Conservative Management in Biliary Ascariasis - A Study of 98 Cases

1970 ◽  
Vol 19 (1) ◽  
pp. 25-28 ◽  
Author(s):  
AS Khan ◽  
B Bhowmik ◽  
HAN Hakim ◽  
MA Islam
Keyword(s):  
Abdominal Pain ◽  
Conservative Management ◽  
Diagnostic Tools ◽  
Biliary Disease ◽  
Common Presentation ◽  
Biliary Ascariasis ◽  
Clinical Presentations ◽  
History Of ◽  
Upper Abdominal

Objectives: History of ascariasis is very old. One quarter of the world's population is known to be infected by ascariasis. It is endemic in various parts of Bangladesh. We aimed to study the various types of clinical presentations, complications and different diagnostic tools and to assess various options for the management of biliary ascariasis. Materials and Methods: Ninty eight cases of hepatobiliary ascariasis were studied over a period of 2 years (April 03 - April 05). All the patients were aged between 12 and 73 years and all were admitted with acute right upper abdominal pain. Ultrasound was the diagnostic tool of choice with 100% results. Results: In this study, biliary ascariasis was found to be more common in females 64.29% (64 patients). The most common presentation was upper abdominal pain in 100% of the patients (98 patients). Complications observed were obstructive jaundice in 08.16% (8 patients), cholangitis in 74.49% (73 patients). History of worm emesis was present in 21.42% (21 patients). Conservative management was successful in 96.94% (95 patients). During follow-up, worm reinvasion of the biliary system occurred in 7.1% (three patients). Conclusion: In endemic countries, biliary ascariasis should be suspected in patients with biliary disease. Most of the patients respond to conservative management. Keywords: Acute upper abdominal pain; biliary ascariasis; Ultrasonography DOI: 10.3329/jdmc.v19i1.6247 J Dhaka Med Coll. 2010; 19(1) : 25-28.

scholarly journals Histopathological analysis of hysterectomy specimens in a tertiary care centre: study of 160 cases

2019 ◽  
Vol 6 (8) ◽  
pp. 2856
Author(s):  
Roopali Jandial ◽  
Mehnaz Choudhary ◽  
Kuldeep Singh
Keyword(s):  
Clinical Diagnosis ◽  
Tertiary Care ◽  
Life Time ◽  
Total Abdominal Hysterectomy ◽  
Clinical Indication ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
Cervical Lesions ◽  
Tertiary Care Centre ◽  
Wide Range

Background: Hysterectomy is the most commonly performed gynaecological surgery as the female reproductive system has been affected by various non-neoplastic and neoplastic conditions during the life time of a woman.Methods: This retrospective study was conducted on 160 hysterectomy specimens reported to Department of Pathology. They were compared in terms of age of the patients and pathology of hysterectomy specimens. The histopathological findings of hysterectomy specimens was noted and these findings were then correlated with clinical diagnosis. The aim of the study was to evaluate the wide range of pathological lesions, commonest pathology involved and correlation of the preoperative clinical diagnosis with the histopathological diagnosis in the hysterectomy specimens.Results: The most common type of hysterectomy was total abdominal hysterectomy with bilateral salpingo-ophorectomy with 102 cases (63.7%). Peak incidence at 5th decade of life in 92 cases (57.5%) was noted. The most common clinical indication was fibroid uterus in 81 cases (50.6%). Proliferative phase of endometrium was the commonest finding in 87 cases (54.3%). In case of myometrium, 95 leiomyomas were noted. On histomorphological study of cervical lesions, chronic cervicitis was commonest finding in 75 (46.8%) cases.Conclusions: Few double pathologies can be missed clinically so clinico-pathological correlation in all cases of hysterectomy has been proved to be important to improve the clinical outcome and post-operative management.

scholarly journals Primary omental infarction: a report of a series of cases in an Indian tertiary care hospital

2020 ◽  
Vol 7 (5) ◽  
pp. 1623
Author(s):  
Ruru Ray ◽  
Ann Sunny ◽  
Giridhar Ashwath ◽  
Anthony Prakash Rozario ◽  
Rahul Sima
Keyword(s):  
Abdominal Pain ◽  
Acute Abdomen ◽  
Surgical Intervention ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Abdominal Abscess ◽  
Short History ◽  
Omental Infarction ◽  
History Of

Primary omental infarction is a relatively rare and often presents as right sided abdominal pain. It is often diagnosed as appendicitis and is usually picked up intra-operatively, or - as often seen nowadays - on imaging. We describe a series of four cases of primary omental infarction that presented to us with varying clinical features. Three of them had a short history of right sided abdominal pain, whereas the fourth patient had a longer history of left sided abdominal pain. All 4 were managed operatively, with the fourth having presented with an intra-abdominal abscess that required laparotomy. Primary omental infarction is a diagnosis which must be considered in any case of acute abdomen. Cases diagnosed with certainty on imaging may be managed conservatively but must be followed up closely. Need for surgical intervention should be considered in select cases.

scholarly journals Post-traumatic rectourethral fistula in an adolescent managed via a transperineal approach using a local gluteal tissue interposition flap: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Toshinori Hirano ◽  
Hiroki Ohge ◽  
Yusuke Watadani ◽  
Shinnosuke Uegami ◽  
Norimitsu Shimada ◽  
...  
Keyword(s):  
Conservative Management ◽  
Fecal Diversion ◽  
Rectourethral Fistula ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Fistula Repair ◽  
Case Presentation ◽  
Clinical Presentations ◽  
Post Traumatic ◽  
Tissue Flap

Abstract Background Rectourethral fistula is a rare disease with a wide variety of etiologies and clinical presentations. A definitive surgical procedure for rectourethral fistula repair has not been established. Case presentation A 13-year-old boy sustained a penetrating injury to the perineum, and developed a symptomatic rectourethral fistula thereafter. Conservative management through urinary diversion and transanal repair was unsuccessful. Fecal diversion with loop colostomy was performed, and three months later, a fistula repair was performed via a transperineal approach with interposition of a local gluteal tissue flap. There were no postoperative complications, and magnetic resonance imaging studies confirmed the successful closure of the fistula. The urinary and fecal diversions were reverted 1 and 6 months after the fistula repair, respectively, and postoperative excretory system complications did not occur. Conclusions The transperineal approach with interposition of a local gluteal tissue flap provides a viable surgical option for adolescent patients with rectourethral fistulas who are unresponsive to conservative management.

scholarly journals A Giant Renal Vein Aneurysm in a Patient with Liver Cirrhosis

2016 ◽  
Vol 2016 ◽  
pp. 1-2 ◽  
Author(s):  
Konstantinos Filis ◽  
George Galyfos ◽  
Ioannis Ketikoglou
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Conservative Management ◽  
Renal Vein ◽  
Pain Therapy ◽  
Unusual Case ◽  
Open Repair ◽  
Imaging Studies ◽  
Diffuse Abdominal Pain ◽  
One Year

We present an unusual case of a 40-year-old female patient with liver cirrhosis and diffuse abdominal pain. The imaging studies revealed a huge renal vein aneurysm. The patient refused any interventional management, despite the risk of possible rupture, and after a week of mild pain therapy, she was discharged. She was followed up closely, and after one year, she remains asymptomatic. Conservative management of such patients has been described before with success. However, open repair or percutaneous thrombosis of the aneurysm remains the indicated therapy, when vein patency is an issue for organ viability.

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