ABSTRACT
This retrospective study was conducted to study the different causes of peritonitis and to determine the surgical outcome. Retrospective study. This study was carried out at the Department of Surgery Peoples Medical College Hospital Nawabshah from 1[st] January 2001 to 31[st] December 2001. In this study of 51 patients of peritonitis admitted, out of them, 16 cases of typhoid ileal perforation, 8 cases of perforated duodenal Ulcer, 7 cases of tuberculosis of those 2 cases were of jujenal perforation and 5 cases of ileal perforation, 4 cases of perforated appendix, 4 cases of ruptured liver abscess, 2 cases of perforated neoplasms of those 1 case each with multiple ileal/ jujenal perforation due to lymphoma ,malignant caecal perforation, gastric perforation, jujenal perforation obstructive/strangulated, infective caecal perforation each, 2 cases of post operative peritonitis, 3 cases trauma, 2 cases of blunt abdominal trauma each developed peritonitis due to ileal and jejunal perforation, 1 case of gunshot injury causing peritonitis due to colon perforation, 2 cases of ruptured ovarian cyst associated with appendicitis. In our study, male to female ratio is 4:1. Maximum frequency was observed in 20-30 years age, whereas most of the patients ranged between 13 to 40 years. Surgical outcome of the peritonitis resulted poor in those cases who came late with hugely contaminated peritoneal cavity when operated. They developed post operative complications i.e. wound infection, septicemia, fecal fistula and longer hospital stays. 22 patient's outcome was poor and out of them 8 patients expired. The mean hospital stay was 23.0 +/- 17.7 days and the range was 67[3-110 days]
ABSTRACT
To compare the stone free rate at one week after extracorporeal shoch wave lithotripsy [ESWL] and ureterorenoscopic [URS] manipulation for proximal ureteric stone [10 - 15 mm size]. Randomized controlled trial. Sindh Institute of Urology and Transplantation [SIUT], Karachi, from August 2010 to February 2011. One hundred and ninety patients with 10 - 15 mm proximal urteric stone, in each group were treated with ESWL and ureterorenoscopic manipulation by using and 8.0 or 8.5 Fr semi rigid ureteroscope. Intracorporeal lithotripsy was performed by using pneumatic lithoclast. The stone free rate were compared between groups by considering size of stone at one week after procedure. The success rate, re-treatment rate, auxiliary procedure and complication rate were compared in each group. Success rate was 49.2% for ESWL and 57.8% for URS [p = 0.008]. The re-treatment rate was significantly higher in ESWL group than in URS group [40% vs. 11 and 18% in URS group]. Although ESWL is regarded as the preferred choice of treatment for proximal ureteric stone, the present results suggest that ureterosrenoscopic manipulation with intracorporeal lithotripsy is a safe alternative, with an advantage of obtaining an earlier or immediate stone-free status. Laparoscopic approaches are reasonable alternatives in cases, where ESWL and URS have failed
Subject(s)
Humans , Male , Female , Lithotripsy , Ureteroscopy , StentsABSTRACT
To assess the complications of suprapubic cystolitholapaxy as an alternative procedure for bladder stones in pediatric age group. Prospective analystical study. This study was carried out in Department of Urology, University of Medical and health sciences Jamshoro from May 2006 to December 2010. this study consisted of 148 patients admitted though the outpatient department of Liaquat University Hospital Jamshoro/Hyderabad. All patients underwent base line and specific investigations especially ultrasound of abdomen and pelvis as diagnostic modality for assessment of bladder stones. Inclusion criteria were all these patients who after counseling for this study and gave written consent parents. Irrespective of their sex and age < 12 years of age presented with bladder stone of < 3cm. Exclusion criteria included were patients having history of previous surgery, posterior urethral valves, stricture urethra and stone > 3 cm were excluded from the study. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. 148 patients, 124 [83.78%] were boys and 24 [16.21%] were girls with ratio 5.1:1 respectively. Mean age of the patients was 5.3 years with range from 1 to 11 years. Twelve [8.1%] patients presented with retention of urine due to impacted stone at bladder neck or prostatic urethra while 16 [10.81%] patients had coexisting renal stones. The mean size of the stones was 1.9 cm with range from 1.1 to 2.8 cm. Total operative time ranged from 25 to 40 minutes. Patients were discharged after observing first void on 2[nd] post-operative day 136 [91.89%] while twelve [8.11%] patients required further stay due to either suprapubic urinary leakage in 5[3.37%] or urinary retention in 7[4.72%] patients. Percutaneous suprapubic cystolitholapaxy is safe and cost-effective alternative to open surgery in children with