ABSTRACT
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.
ABSTRACT
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.