Role of laparoscopy in blunt abdominal trauma

To evaluate the role of laparoscopy in the diagnosis and management of blunt abdominal trauma. This descriptive, prospective study was conducted in the departments of surgery, Ghulam Mohammad Mahar Medical College, Sukkur and Chandka Medical College, Larkana, Pakistan from June 2010 to May 2012. It included 32 patients with blunt abdominal trauma admitted in emergency at GMMMC, Sukkur and at CMC Larkana. Initially, all were resuscitated with iv fluids, analgesics, iv antibiotics and blood transfusion, if required and then investigated by ultrasound abdomen, plain x-ray abdomen and chest and other routine investigations. Laparoscopy was performed in hemodynamically stable patients not showing free gas under the diaphragm in plain x-ray abdomen and ultrasound showing hemoperitoneum. The patients with penetrating abdominal wounds, non-traumatic abdominal emergencies and iatrogenic injuries were excluded. Out of 32 parents, 29 were male and only 3 were female. The age ranged from 12 to 60 years. The organs injured were spleen in 5 [15.6%] patients, liver in 17 [53.12%], omental bleeding in 2 [6.25%], small bowel mesenteric bleeding in 6 [18.75%] and associated Jejunal [injuries in 2 [6.25%] patients. Only 3 [9.37%] patients with Grade-iii liver injury developed post- operative collection, 1 [3.12%] patient developed biliary fistula and 1 [3.12%] developed right sided pleural effusion. No post-operative bleeding or mortality was recorded. Laparoscopy could be useful in selected patients with blunt abdominal trauma as a diagnostic and therapeutic tool, thus avoiding unnecessary laparotomies

Frequency of HBs Ag and anti-HCV in trauma patients

This study was carried out to determine the frequency of Hepatitis B and C Viral infection in patients undergoing emergency surgical operations after trauma, and to evaluate the associated risk factors. Descriptive Study. This study was conducted at General Surgical, Orthopaedic and Paediatric Surgery Department of Ghulam Muhammad Mahar Medical College Hospital Sukkur from May-2011 to April-2012. All the patients who were admitted in the Surgical and orthopaedic department for emergency surgical operations followed by trauma were included in the study. The patients were screened for HBsAg and Anti-HCV using immunochromatography [ICT] method. Those who were weak positive by ICT were further confirmed by Enzyme Linked Immunosorbent Assay [ELISA]. 592 patients were admitted in Surgical and orthopaedic department during a period of last one year for emergency operations after trauma and were screened for HBsAg and Anti-HCV. Out of these 592 patients 472 [79.7%] were males and 120 [20.27%] were females. Mean age of these patients was 40 years. After screening, 33 [5.57%] patients were found HBsAg positive and 117 [19.76%] were Anti-HCV positive, while 09 [1.5%] were positive for both. Hepatitis-B was found in 21 [2.3%] males and 12 [1.3%] females, while Hepatitis-C was predominantly found in 68 [7.44%] males and 49 [5.36%] female patients. Parenteral injections by Quacks, previous surgery, blood transfusion and shaving by barbers were found to be the risk factors. High frequency of HBs Ag and Anti-HCV was found in trauma patients undergoing emergency surgery. Our message is that "Prevention is better than cure". So it is essential to prevent the spread of Hepatitis B and C by screening every patient before surgery and counseling of patients