ABSTRACT
Objectives: The purpose of this study is to share our surgical experience of duodenal injuries management and to evaluate outcome of different surgical procedures
Study Design: case series
Place and Duration of Study: Surgical emergency Allied hospital Faisalabad from 01 June 2012 to 31 may 2014
Methods: All patients with traumatic duodenal injuries were included. Data included patient's profile, date of admission, mechanism of injury, grade of duodenal injury, type of procedure, and outcome
Results: Total number of cases in period under study was 29. There were 26 [89.7%] male and 3 [10.3%] female and mean age of 27.8 years. 62% cases were due to blunt abdominal trauma commonly road traffic accident and 38% penetrating injuries predominantly firearm injuries. Second part of duodenum was found to be the most commonly injured site in 55.17% case and grade II injuries accounted for 65.52% of total injuries. The most common operative procedure performed was Primary repair. Postoperatively 10.34% cases developed duodenal fistula, and the overall morbidity was found to be 34.48% and mortality 31%
Conclusion: It is concluded that blunt trauma abdomen is common cause of duodenal injury in our setup. Most injuries can be managed by primary repair. Early diagnosis and surgical intervention is most important factor for good results
ABSTRACT
Background: It is a single blind controlled prospective comparative study in which Open preperitoneal herniorraphy [OPH] is compared with conventional anterior approach i.e. Darning repair, regarding early complications [like pain, swelling, infection etc]and recurrence rate
Patients and Methods: The study was conducted in Surgical Unit-I Services Hospital Lahore over the period of 3 years from Jan 2002 to Dec 2004.A total of 80 patients of Inguinal Hernia were selected randomly for OPH and Darning repair. Only males over the age of 12 years without any co-morbid disease, admitted through OPD were selected for study. The patients were operated on elective list under General or Spinal Anesthesia. Postoperatively patients were kept in ward for at least 24 hrs and they were routinely followed up for 2 years on out-door basis after discharge
Results: Mean operation time for OPH 30 mins [20-60 mins] was shorter than Darning repair 45 mins [30-80 mins]. Most patients had mild pain after OPH [60%] as compared to Darning repair [40%]. The median time to return to work after OPH [2 weeks] was less than after Darning repair [4 weeks].But the incidence of subcutaneous haematoma formation [5%] was same after both types of repairs and there was no recurrence [0%] seen after 2 years, on follow-up
Conclusion: In conclusion Open-preperitoneal herniorraphy is better than conventional Anterior approach in terms of less operative time, post-op pain, early return to work, although there was no recurrence seen after both types of repairs