Colonic Injury

 During  January  1992  through  November  1995, 45 patients  who  sustained  colonic  injuries  were  retrospectively  analyzed.  Thirty-eight  were men  and  7  were  women, their  mean  age  was  29  years.  Blunt  abdominal  injury  from  traffic  accident  was  the most  common  cause. The indication  to  perform  laparotomy  was  based  on  physical  findings  more  than  diagnostic  peritoneal  lavage  or  other  investigation.  Right  side  colon  was  the  most  common  location  of  injury  and  multiple  colonic  injuries  was  found  in  One –third  of  cases.  Ninty-one percent  of  patients  had  associated  intra  or  extra – abdominal  injuries.  Primary  repair,  include  simple  repair  and  resection  with  primary  anastomosis,  was  carried  out  in  most  cases.  Colostomy  was  performed  in  5  cases.  Pneumonia  and  wound  infection  were  common  complications.

The abdominal cocoon, a case report and a review of literature.

 The abdominal cocoon is a rare cause of intestinal onstruction in young and adolescent girls. It characterized by encasement of the small intestine in fibrous tissue. The diagnosis is often made at laparotomy for acute or chronic intestinal obstruction. The treatment  of choice is sinple excision of the fibrous tissue. This condition was first described by Foo et al in 1978, and until September 1993 only 25 cases have been reported in English literature. This paper reports a case who was admitted and operated recently at the Srinagarind  hospital , Faculty of Medicine, Khon Kaen University.

Outcome of Inpatient Trauma Cases : Accident and Emergency Khon Kaen University.

Objective : To study  the outcome of inpatient trauma cases of Accident and Emergency  Unit, Department of Surgery, Faculty of Medicine, Khonkaen university compared with the result of Khon Kaen Hospital and standard outcome. Method : We retrospectively studied trauma patients who was admitted in Accident and Emergency Unit, Department of Surgery, Faculty of Medicine, Khon Kaen university between 1 January 1997 to 31 December 1997. TRISS score has been calculated to define the survival probability (Ps) of all 291 patients and stratified into 3 groups. We compared the actual death of each group to the outcome study of Khon Kaen Hospital (n=2492). We also used Z-statistic to compared the actual survivors and expected survivors from TRISS norms.Result : The actual death of Non-preventable death group, Potentially preventable death group and Preventable death group were 41.67%, 45.45% and 6.39% respectively. The outcome study of Khon Kaen Hospital in each group were 87.6%, 67.7% and 2.8% respectively. The Z-score was – 0.02306 (P = 0.008 – 0.01)Conclusion : In Non-preventable death group (Ps 0.00-0.25), the outcome of treatment was better than the outcome study of Khon Kaen Hospital In Potentially preventable death group (Ps 0.25-0.50), no statistically difference between the 2 studies In preventable death group (Ps 0.50-1.00), the outcome study of Khon Kaen Hospital was better than outcome of Accident and Emergency Unit The Z-score  -0.02306 indicated no statistically difference between number of actual survivors and expected survivors from TRISS norms.