Intra-abdominal pathologies

To evaluate relative frequency, reasons, avoidable responsible factors and outcomes of relaparotomy. Observational case series study. Department of Surgery Unit III BVH Bahawalpur. From 01-9-2009 to 31-8-2010. All the patients who presented in surgical outdoor, indoor and casualty department with severe intra-abdominal pathologies after primary laparotomies referred from low level, secondary care and tertiary care hospital and underwent relaparotomy electively or on demand were included in the study. Retrospectively their demographic characteristics, initial diagnosis with surgical information of primary laparotomy, factors and outcomes after relaparotomies were analyzed statistically. A total 54 patients were included in the study with male to female ratio of 1:2. Mean age of the study group was 30.91 +/- 12.5 years. Relative frequency of relaparotomy was 5.6%. Common center of referral was low level hospital 66.7%. Most common indication of relaparotomy was peritonitis in 52%. Most common complication of relaparotomy was wound infection 74%. Avoidable factors responsible for relaparotomies were found to be surgery at low level hospitals [77.3%] and by nonqualified surgeons [72.1%]. The rate of relaparotomy is very high because of unsupervised primary surgery in institutions and surgery by unqualified operators in private sector. Many of these are avoidable. In addition to decreasing the complication rate, primary surgery performed at tertiary care hospitals would decrease need for patients to undergo re-exploration

Pilonidal sinus: prevalence and comparison of excision and primary closure with lay open procedures

To study the prevalence of pilonidal sinus and compare the outcome of the excision and primary closure with lay open surgical procedures. Prospective randomized comparative study. Department of surgery, Bahawal Victoria Hospital Bahawalpur. From 1st December 2002 to 30th November 2007. A total of 40 patients with pilonidal sinus were randomized into two groups. Group I underwent excision and primary closure while Group II underwent excision and lay open procedure. Patients of Group I and II had comparable mean operation time of 42.7 minutes. Group I patients had a shorter mean hospital stay of 4.87 days, earlier return to light work after 13.21 days, less treatment expenses and low rate of postoperative complications and good patient satisfaction. We conclude that primary closure after excision of pilonidal sinus is superior surgical procedure than excision and laying it open

Unusual presentation of carcinoma of penis

A case of carcinoma of the penis in a 55-year-old landlord is described. He presented with a fungating growth on the shaft of his penis with an unusual history. The lesion started as a nodule in the coronal sulcus leading to thinning of urinary stream and ultimately retention of urine, which was diagnosed and treated as a case of urethral stricture. Wedge biopsy of the growth revealed the case of squamous cell carcinoma of penis. Ultrasonography and CT scan of pelvis and abdomen proved the disease to be localized to penis and total penectomy was carried out