ABSTRACT
Background: Acute appendicitis is one of the commonest surgical emergencies. Authors undertook this study to evaluate serum bilirubin levels in acute appendicitis and appendiceal perforation.Methods: A retrospective study evaluating the serum bilirubin levels in acute appendicitis and appendiceal perforation was carried out for 6 years at three tertiary care hospitals at India from 2014 to 2019. Patients having acute appendicitis and appendiceal perforation, confirmed on histopathology, with no other medical or surgical comorbidity were included in the study.Results: The total number of our study subjects was 927. 306 patients had appendiceal perforation, amongst these, 226 (74%) had hyperbilirubinemia. Out of the 621 patients having acute appendicitis only 186 (30%) had hyperbilirubinemia. The lowest and the highest serum bilirubin levels of this study group were 0.6 and 3.1 mg/dl, respectively, with an average of 1.6 mg/dl. In patients diagnosed to be having acute appendicitis, the lowest and highest serum bilirubin levels were 0.6 and 2.4 mg/dl, respectively, with an average of 1.3 mg/dl. As for the patients having appendiceal perforation the lowest and highest serum bilirubin levels were 0.8 and 3.1 mg/dl, respectively, with an average of 1.8 mg/dl.Conclusions: Hyperbilirubinemia is seen in acute appendicitis but predominantly in appendiceal perforation, so serum bilirubin estimation may help us in diagnosing appendiceal perforation pre-operatively if and when used in conjunction with other available diagnostic modalities.
ABSTRACT
Anal stenosis is a rare but serious disabling condition following ano rectal surgery, anal trauma, carcinoma, post radiotherapy and Crohn's disease. 90% of the anal stenosis is causes by overzealous haemorrhoid surgery. Stricture following sclerotherapy is also mentioned in the literature. In our cases disabling anal stenosis was for last 1 year following sclerotherapy of haemorrhoids leading to severe anal stenosis with diaphragmatic ring like annular stenosis. A formal Y-V anoplasty was performed which relieved the patients of their symptoms leading to satisfactory bowel movements.
ABSTRACT
Extra adrenal pheochromocytomas (EAPs) commonly arise in the organ of Zuckerkandl. There presentation symptoms are similar to pheochromocytomas. Biochemical investigation demonstrating elevated blood and urine catecholamines and there metabolites along with imaging studies such as ultrasonography (USG) ,CT, MRI and 131I labeled MIBG (meta-iodobenzylguanidine) scan help in achieving the diagnosis.We present a 35 yr old adult female, who presented with severe headache, abdominal pain and episodes of vomiting , examination revealed a firm to hard retroperitoneal mass right to umbilicus, she was hypertensive and had raised urinary VMA. Clinically an extra adrenal paraganglinoma was suspected . USG abdomen and CT guided FNAC confirmed the diagnosis.Tumor was removed with right mid laparotomy leading to cure of disease.
ABSTRACT
Trichobezoar is a ball of swallowed hair that collects in the stomach and fails to pass through the intestine. The risk is greater among mentally ill females. Here in we describe a mentally normal female presenting with acute abdomen and firm mass in the abdomen with muscular defence.