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Aim: Now GIST is recognised as the most common mesenchimal tumour of the GI tract, though until recently this clinical entity was ill defined. The aim was to study the incidence mode of clinical presentation, type of surgery and histopathological study of the tumour. Methods: This study was carried out on 40 patients at SCB Medical College, Cuttack, Odisha. Results: Incidence sex and anatomical site affected, is nearly same to international statistics. Conclusion: Highest incidence of GIST is in between50-60 years with male predominance. Most of the patients were resectable with spindle type as the most common histological type.
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This is a study conducted in a tertiary care hospital in eastern India aiming to provide detailed description of etiology progression and management of acute small bowel obstruction in our patients. Methods: Around 215 patients presented with features of acute intestinal obstruction.All presented with pain abdomen ,vomiting and distension and constipation. Results: Subsequently 58 patients managed conservatively and rest 157 patients managed surgically.In most of the patients multiple air fluid level are the most common radiological findings.External hernias (34.4%) are the most common causeof acute small bowel obstruction.Resection and anastomosis(24.8%) done in of strangulated bowel and rest are managed by hernia repair, adhesiolysis and stomy formation,Wound infection are the most common post-operative complication. Morbidity(2%) and mortality was mainly due to old age and late presentation. Conclusion: In all cases early diagnosis and surgical intervention are the keys to reduce complications and mortality.
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Throughout the evolution of surgery, peritonitis has been a continuous diagnostic and therapeutic challenge. Even in some centers, due to lack of armament surgeons has to depend more on the clinical risk factors for diagnosis and early management. The aim of this study was to risk factors affecting the mortaliity in Acute Diffuse Peritonitis. Materials and methods: This was a prospective evaluation of 120 patients high risked emergency patients of acute diffuse peritonitis who were selected randomly from a single center. Results: The overall mortality in the study group was 11%. Significant risk factors in the analysis included advanced age >50 years (p=0.02),delayed duration of presenting symptoms >24 hours (p=0.002). All the patients were high risked emergency patients and immediate intervention with proper evaluation had been managed to change the fate of these patients.
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Background: Gastrointestinal and mesenteric injuries are the third most common type of injury from blunt trauma abdomen and are associated with high rates of morbidity and mortality.Objectives: To determine the clinico-demographic profile, localization of injury, diagnostic and management methods and the outcome in cases of hollow viscus injury (HVI) following blunt trauma abdomen which were admitted to our unit. Methods: Records of patients who were admitted emergently with gastrointestinal injuries and blunt abdominal trauma between July 2014 and July 2016 were reviewed retrospectively. Results: The study group comprised 65 patients with mean age of 33.3 ± 16.2 years and a male predominance (89.2%). The commonest cause of injury was road traffic accident in 44 (67.7%) cases. Ileum was the most common site of injury detected in 31 (41.3%) followed by jejunum in 26 (34.7%) cases. Treatment comprised primary closure of perforation in 48 (64%) cases, segmental resection and anastomosis in 22 (29.3%), and stoma in 5 (6.7%) cases. Three out of 5 cases of anastomotic leak occurred in patients who were operated at 8-24 hours or beyond. Associated injury to intra-abdominal solid viscera and other sites were present in 30.7%. The mean duration of hospitalization was longer in patients with associated injuries as compared to those with isolated HVI (12.2±4.6 days versus 9.3±0.8 days). Conclusion: Early diagnosis followed by prompt surgical intervention and careful monitoring for associated injuries is the key to favourable outcome in blunt HVI.
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Background: Aim-In recent times there has been an increase in the incidence of obstructive jaundice, especially due to malignant cases. The aim was to diagnose compare the surgical procedures to palliative procedures. Methods: This study was carried out on 125 patients at S.C.B Medical College, Cuttack, Odisha. The diagnosis of mechanical obstruction to the biliary tree is difficult at times as the clinical features and biochemical investigation results may be atypical. Results: Non operative management with endoscopic stenting and interventional radiological procedures (PTBD) was a choice in certain group of patients. Conclusion: Majority of the tumors are in the head of the pancreas (56.8%). The maximum age incidence of malignant obstructive jaundice is between 51 years and 60 years (28.8%). Moderately differentiated adenocarcinoma is the histology in 41.7% of the cases, poorly differentiated adenocarcinoma in 41.7% of the cases and well differentiated in 16.7% of the cases.
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Background: The main type of tuberculosis of interest to any hospital- based surgeon is intestinal, the clinical presentation of which varies from one of an acute abdomen to one of a protracted cause of ill health and morbidity with a notorious reputation for poor response to therapy, both conservative as well as surgical. Low socio- economic status and malnutrition in our country are very important causes of the high prevalence of pulmonary tuberculosis, and with superadded problems of overcrowding and poor access to good sanitation and neglect for medical attention, extra pulmonary forms of tuberculosis also form a sizeable proportion of the case load of tuberculosis. The major source of infection is the open untreated case of pulmonary tuberculosis. Methods: Presented here is a brief account of hospital- based study of the presentation of 50 cases of abdominal tuberculosis and its management in both the acute as well as chronic setting, carried out at the S.C.B Medical College, Cuttack, Odisha. Results: In our study 40% patients presented with signs of intestinal obstruction, 6% with perforative peritonitis, 34% with diffuse or well defined lump and 54% with ascites. All these patients underwent biochemical, radiological and endoscopic investigations. 26 patients underwent surgical treatment, Out of these 26 patients, 14 were operated in emergency and 12 were operated electively, Emergency surgeries were performed after correction of fluid electrolyte imbalance. Of the 14 emergency cases, 3 patients underwent resection anastomosis of small bowel. 6 patients underwent right hemicolectomy for iieocaecal tuberculosis. Conclusion: In this study 60% patients had an acute and subacute presentation and 40% patients had a chronic presentation.
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A 24-year-old female presented with swelling in the left breast for one-and-a-half years associated with pain for last 4 months. During this period, she was operated twice and once again there was local recurrence, the biopsy was interpreted as benign vascular lesion. The case was diagnosed by preoperative cytology as angiosarcoma of breast, after which, she underwent modified radical mastectomy. Angiosarcoma of breast is uncommon with extremely bad prognosis. Familiarity with the clinical and pathologic features is critical in avoiding underdiagnosis and delayed treatment.