ABSTRACT
External duodenal fistulae from sutured duodenal ulcer perforation sites are difficult to manage and most patients succumb to septicemia and undernutrition. This is due to failure of closure of the perforation site in the duodenum. Most techniques described in the past to facilitate closure have failed to give satisfactory results. We have devised a new procedure where the duodenal ulcer perforation is closed by mobilizing the gall bladder. A hole is made in the fundus of the gall bladder and it is anastomosed to the freshened edges of the duodenal opening. We have treated six patients by this technique. In five patients the leak was satisfactorily sealed. Three patients died - one due to persistent leak and two due to jejunostomy leak.
Subject(s)
Anastomosis, Surgical , Digestive System Fistula/etiology , Duodenal Ulcer/complications , Duodenum/surgery , Gallbladder/surgery , Humans , Peptic Ulcer Perforation/surgery , Postoperative Complications/etiology , Retrospective Studies , Suture Techniques , Treatment OutcomeABSTRACT
Though rupture of hepatic hydatid cyst is not uncommon, fistulization into the gut following rupture is rare. We report a case in whom a hepatic hydatid cyst ruptured into the first part of the duodenum.
Subject(s)
Adult , Biliary Fistula/etiology , Diagnosis, Differential , Duodenal Diseases/etiology , Echinococcosis, Hepatic/complications , Humans , Intestinal Fistula/etiology , MaleABSTRACT
BACKGROUND: Recurrence and incontinence are common after conventional surgery for fistula-in-ano. Medicated seton (ksharsootra) is a time-tested therapy. METHODS: Seton treatment was given to 114 patients with anal fistulae. The initial loose seton was changed weekly to achieve fistulotomy. RESULTS: Application of non-medicated seton did not show any cutting action; hence all patients were treated with ksharsootra after 3 weeks. Anal discharge (n = 114) and burning pain (35) were noted in the first 48-72 hours. The cut-out rate was around 1 cm/week, with mean cut-out time 8.3 weeks (range 3-18). All wounds healed well and patients remained ambulatory. Local induration developed in 18 patients; four had an abscess. There was no incontinence or recurrence over a follow-up of 6 months to 2 1/2 years. CONCLUSIONS: Ksharsootra treatment for anal fistulae is safe and effective, with low complication rates.
Subject(s)
Adolescent , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Medicine, Ayurvedic , Middle Aged , Phytotherapy , Rectal Fistula/diagnosis , Retrospective Studies , Safety , Suture Techniques , Treatment Outcome , Wound HealingABSTRACT
We report a case of ileal schwannoma who presented with bleeding per rectum. Three-vessel angiogram was the only diagnostic investigation, and revealed tumor blush in the mid-ileal region. On exploration, an intraluminal mass was found in the mid-ileal region along with a feeding vessel in the mesentery. Resection of the involved ileum with end-to-end anastomosis was done. Histopathology showed benign schwannoma of ileum involving the submucosa, muscularis propria and serosa.
Subject(s)
Aged , Angiography , Humans , Ileal Neoplasms/diagnosis , Male , Melena/etiology , Neurilemmoma/diagnosisABSTRACT
Thyroid abscess arising from Acute Suppurative Thyroiditis (AST) is a rare clinical disorder. The ability of the thyroid gland to resist infection is well known and infection in the thyroid gland is rare, particularly so with the advent of widespread usage of antibiotics. An internal pharyngeal fistula (Pyriform sinus fistula) is the most common underlying abnormality in patients with AST. We report a case of an adult male who presented with a thyroid abscess. The causal organism was found to be Staphylococcus aureus. Intravenous antibiotics and, incision and drainage of the abscess led to an uncomplicated recovery.