International Surgery Journal
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2349-2902, 2349-3305
Updated Sunday, 28 November 2021

2021 ◽  
Vol 8 (12) ◽  
pp. 3723
Author(s):  
Anandi A. ◽  
Preethy R. ◽  
Rani Suganya R. ◽  
Jothiramalingam S.

Sclerosing encapsulating peritonitis (SEP) is a visceral encapsulation syndrome of inflammatory origin, seen as an infrequent cause of intestinal obstruction in young patients. It is a condition characterised by complete encapsulation of small bowel loops by a fibrocollagenous membrane, leading to cocoon formation. Histologically, the membrane is composed mainly of organised fibrin, probably derived from the plasma exudation of peritoneal microvasculature. Clinical presentation is related to the development of altered gut motility, resulting in abdominal pain and features of intestinal obstruction. We here discussed about a young patient who presented with features of intestinal obstruction and diagnosed with SEP, secondary to abdominal tuberculosis and was then treated surgically. SEP as a cause of intestinal obstruction is a rare life threatening entity encountered in day to day practice. Definitive diagnosis of this condition is challenging in the pre-operative period and is usually missed and a high index of suspicion is required. 


2021 ◽  
Vol 8 (12) ◽  
pp. 3738
Author(s):  
S. P. Gayathre ◽  
M. Kudiyarasu ◽  
Bala Brindha Saugunan ◽  
R. Kannan

Obturator hernia is a rare type of pelvic hernia in which intraperitoneal contents protrude through the obturator foramen and is most commonly found in females. It accounts for about 1% of all abdominal hernias and possesses a great diagnostic challenge due to the non-specific symptoms and meagre clinical signs. Hereby we report a case of obturator hernia in an nonagenarian emaciated fragile old lady who presented with features of acute Intestinal obstruction and was diagnosed using computed tomography as right sided obturator hernia and eventually was taken up for emergency laparotomy. The herniated segment was resected and anastomosis was done with primary closure of the defect. Postoperative period was uneventful and the patient was discharged on postoperative day 7. 


2021 ◽  
Vol 8 (12) ◽  
pp. 3511
Author(s):  
Chandra Prakash Roushan ◽  
Ganesh Kumar Sah ◽  
Prince Mandal ◽  
Dinesh Prasad Koirala ◽  
Geha Raj Dahal

Background: Clinical features of acute appendicitis are often overlapping with other abdominal pathology in children. This increases the risk of complicated appendicitis (CA). It is still difficult to identify CA preoperatively. The study aims to identify pre operative risk factors in children for CA.Methods: A prospective study was conducted in pediatric surgery unit of department of general surgery of a university hospital of Kathmandu, Nepal. All children up to 16 years diagnosed and operated for appendicitis were included in the study. Based on intraoperative findings and histopathological examination (HPE), patients were grouped in simple appendicitis (SA) and CA. Pre-operative clinical and laboratory variables of between simple and CA were compared. P£0.05 was considered as significant.Results: A total of 73 children were included out of which 61 (83.6%) had SA and 12 (16.4%) had CA. Mean age of participants was 12.8±2.9 years. More than half (64.4%) of the participants were male. The median duration of symptoms was 2 days. In bivariate analysis, gender, serum Na, duration of symptoms and rebound tenderness were significantly associated with severity of appendicitis. In multivariate analysis, rebound tenderness (OR-15.36) and duration of symptoms (OR-9.96) were found to be associated with CA.Conclusions: Male patients, rebound tenderness, longer duration of symptoms and hyponatremia can be used to predict CA. Duration of symptoms and rebound tenderness are independent risk factors for CA.


2021 ◽  
Vol 8 (12) ◽  
pp. 3668
Author(s):  
Gomalaadevee Rajaram ◽  
Pavin Kaur Bal Baldev Singh ◽  
Muhammad Firdaus Bin Madzlan ◽  
John Emmanuel Gilbert Fernandez ◽  
Nurdaliza Binti Mohd Badarudin

Meckel’s diverticulum (MD) is a congenital abnormality of the gastrointestinal tract resulting from incomplete obliteration of the vitellointestinal duct by 5th to 7th week of gestation. Incidence is 2% in the general population with a 2:1 male to female ratio. The various presentations of MD include gastrointestinal bleeding, intestinal obstruction, diverticulitis and intestinal perforation. Majority of the MD is asymptomatic however the potential risk of developing complication it's about 4-6%. Preoperative diagnosis of MD is challenging. We present 6 cases of MD managed at our centre over the course of 1 year. Two cases presented as intestinal obstruction secondary to mesodiverticular band from MD, one case with bleeding, two cases with intussusception and one case of meckel’s diverticulitis.


2021 ◽  
Vol 8 (12) ◽  
pp. 3501
Author(s):  
Ruksana Parvin ◽  
Ahmed Sharif ◽  
Mosammat Bilkis Parvin ◽  
Kazi Sohel Iqbal ◽  
Golshan Ara Kohinoor ◽  
...  

Background: The incidence of breast abscess ranges from 0.4 to 11% of all lactating mothers. Although breast abscess is a serious common complication of mastitis with high morbidity rate, there is a lack of high-quality randomized trial to demonstrate the best treatments.Methods: The Study was conducted in the Department of Surgery of Universal medical college and hospital, Dhaka, Bangladesh and MH Samorita hospital and medical college. It was a randomized controlled trial to see the efficacy of primary closure following incision and drainage of lactational breast abscess over traditional open method. Total 120 population were randomly selected in group A (60 patients) and group B (60 patients) and data was collected with their signed ethical consent. The study was conducted from January 2014 to December 2019. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using Statistical package for social sciences (SPSS) version 22.Results: In patients of group A, most breast abscesses healed successfully with a nicer circumareolar scar, earlier healing, lesser number of hospital visits and lower total cost as compared to patients in group B. There was early resumption of breastfeeding and better patient satisfaction seen in group A.Conclusions: Primary closure of lactational breast abscess following incision and drainage is an effective modality of treatment of lactational breast abscess and it should be the first line of treatment, especially for larger and multilocular breast abscesses while traditional incision and drainage should be reserved for abscesses with gangrenous skin changes, where primary closure is not justified.


2021 ◽  
Vol 8 (12) ◽  
pp. 3558
Author(s):  
Anoop Yadav ◽  
Satish Kumar ◽  
Sanjay Marwah ◽  
Narottam S. Argal ◽  
Chander M. Yadav ◽  
...  

Background: The small bowel perforation peritonitis is one of the main causes of generalized acute peritonitis in developing countries.The aim is to find out the prognostic factors affecting the mortality and morbidity of non-traumatic small bowel perforations.Methods: A total of 50 patients of any age and either gender of non-traumatic small bowel perforation peritonitis were included and studied prospectively. The prognostic evaluation was assessed by the impact of pre-operative prognostic factors and per operative findings on post-operative complications and mortality.Results: One third of the patients were of 20-30 years of age followed by 18% who belonged to 10-20 years age group. Operative findings revealed mean duration of surgery was 2 hours. Majority of patients (33) had bilio-purulent peritonitis. Post-operative pulmonary complication revealed 56% (28 out of 50) patients were having pulmonary complications. Post-operative wound complication showed surgical site infection as the most common complication noted and managed by sending wound culture and changing antibiotics. Second most common was burst abdomen managed initially by dressing and thereafter secondary wound closure. Delay in intervention (DII) had significant correlation with world society of emergency surgery (WSES) score and amount of peritoneal fluid.Conclusions: Most common cause of non-traumatic small bowel perforation was typhoid ileal perforation with most common presentation being pain abdomen. The significant factors defining the outcome of these patients were volume of intra-peritoneal fluid (purulent/fecal) >1000 ml, WSES score >6 and Mannheim’s peritonitis index (MPI)>18.


2021 ◽  
Vol 8 (12) ◽  
pp. 3727
Author(s):  
Prawin Kumar Singh ◽  
Rakesh Kumar Sahu

Intussusception of the bowel is defined as the telescoping of a proximal segment of the bowel within the lumen of an adjacent segment. This condition is a common cause of intestinal obstruction in children below two years of age. It is considered a rare cause of intestinal obstruction in the adult. It accounts for 5% of all cases of intussusception and 1-2% of all cases of intestinal obstructions in the adult population. Almost up to 20% of cases are idiopathic and they are not having any lead point pathology. The rest of the cases are caused by organic lesions like Meckel’s diverticulum, benign and malignant lesions, metastatic neoplasm, intestinal polyp, etc. In adults’ preoperative diagnosis is difficult and a definitive diagnosis is made at laparotomy. Computerized tomography is the most sensitive diagnostic modality for this condition.


2021 ◽  
Vol 8 (12) ◽  
pp. 3758
Author(s):  
Sibasankar Dalai ◽  
Aravind V. Datla

Stroke is the third leading cause of death and disability in the world. Carotid artery stenosis due to atherosclerosis accounts for 20 to 30% of all strokes. The patients can be asymptomatic or present with a transient ischemic attack or stroke. Diagnosis is based primarily on imaging modalities like carotid Doppler, CT (Computed tomography) angiogram, MR (Magnetic resonance) angiogram or DSA (Digital subtraction angiogram). Treatment options include optimal medical therapy, carotid endarterectomy-touted as the gold standard for treating significant carotid stenosis; and carotid artery stenting, whose safety and efficacy have undergone significant improvements due to technological advances in the field. We presented a review of the literature outlining the various aspects of atherosclerotic carotid stenosis and the findings of several randomized controlled trials conducted to settle the debate between endarterectomy and stenting for carotid stenosis. 


2021 ◽  
Vol 8 (12) ◽  
pp. 3702
Author(s):  
Maria C. Gonçalves ◽  
Inês C. Gonçalves ◽  
Mafalda Salvado ◽  
Sara Diniz

Gallbladder cancer is the 5th most common gastrointestinal cancer, is 2-3 times more frequent in females, and gallstones represent the most important association with this type of cancer. It is generally diagnosed incidentally after cholecystectomy for cholelithiasis and complete surgical resection offers the only potential cure. We report a case of a 42-year-old female, previously healthy, with upper right quadrant pain for 2 weeks and an ultrasound suggestive of cholecystitis. Unfortunately, intraoperative findings were discouraging.


2021 ◽  
Vol 8 (12) ◽  
pp. 3717
Author(s):  
Reshma Bhalchandra Mohite ◽  
Vishaka Iyer ◽  
Anant N. Beedkar ◽  
Sarojini Jadhav

Amyand’s hernia is defined as the hernia with appendix normal, inflamed or perforated as content. 1% of inguinal hernias are Amyand’s and amongst them 0.1% contains inflamed appendix. Commonly encountered on right size due to anatomical position of appendix. Left Amyand’s is rare and associated with intestinal malrotation, situs invertus and mobile caecum. Here, we presented an interesting case of left irreducible hernia in 70 years old gentleman with no signs of acute obstruction or strangulation, patient underwent emergency laparotomy in which hernial sac contents were inflamed ileal loop, inflamed appendix and perforated caecum in 70 years old man is rare presentation and not reported in any literature as per our knowledge. Resection of inflamed bowel loop with ceacum done along with ileo ascending anastomosis with primary tissue repair done. Post-operative period was uneventful. Hernia sac contents are most of the time surprising and their management sometimes differ according to the content. Appendix in hernia sac is found in 1% of all hernia but lack of facility for the pre-operative diagnosis and varied presentation it is challenging to diagnose and operate accordingly.  


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