ABSTRACT
Background:Hollow visceral perforation is the commonest perforation among all the hollow viscera in the body. The perforation can be traumatic or non-traumatic and it constitute commonest surgical emergency worldwide. The diagnosis of perforation can be made clinically but for confirmation basic radiological investigations and sometimes special investigation are required. Methods:This is a prospective observational study conducted in our institute in the Department of General Surgery. The patients who are included in this study were more than 15 years of age in both sexes having hollow visceral perforation presenting in accident and emergency department.Results:Out of 624 patients, 530 (84.93%) were males while only 94 (15.06%) were females, with a male: female ratio of 5.63:1. The site of perforation are ileum 37.01% duodenum, 28.36% maximum sites of hollow viscous perforation. Acid peptic disease was the cause of perforation in 27.40% of 171 cases. Enteric fever accounted maximally for 29% of 181 cases and all in the ileum. Acute appendicitis resulted in perforation of the appendix in 64 cases (10.25%) while blunt trauma abdomen causes perforation in 12.66% of 79 cases. Perforation due to stab injury accounted for 5.12% and fire arm injury perforation seen in 19 patients (3.04%).Conclusions:Early diagnosis of perforation, resuscitation with crystalloids with broad spectrum antibiotic coverage and urgent surgical intervention whenever patient is fit for anaesthesia are the important factors which decides the ultimate fate of the patient in case of hollow visceral perforation peritonitis.
ABSTRACT
Introduction: Deep venous thrombosis (DVT) of lower limbsis one of the most common cause for the majority of deathscaused by pulmonary embolism. Deep vein thrombosis is theformation of blood clots in the deep veins which commonlyaffects the leg veins such as the calf veins, femoral vein, orpopliteal vein or veins of the pelvis. The aim of the studywas to evaluate clinical profile of patients in form of age,sex, etiological factors of deep venous thrombosis in ourinstitute. Also study risk the factors in patients of deep venousthrombosis.Material and Methods: Study was a prospective studywhich was conducted on 108 symptomatic patients of deepvein thrombosis which were proved by colour dopplerultrasonography. All patients who were more than 18 years ofage and either sex were taken into study.Results: In our study 37.03% of the patients were malesand 62,97% were females with majority belonging to 21-30 years of age group (33.82%). In this study the youngestpatient was 20 years old female and the oldest patient was96 years old female. Male: Female ratio was 1:1.7. The leastcommon age group affected is extreme of age i.e. ≥ 20 yearsand > 60 years of age in both sexes. The most common limbaffected is left lower limb 62 patients (57.40) and right limbinvolvement is seen in 39.81% of patients. Bilateral lowerlimb DVT is present in two patients and one patient was upperlimb DVT. Predisposing factors associated with thrombosisin deep veins maximally seen in 46 patients in 42.59% due tounknown cause. Pregnancy and post-partum was the secondmost common predisposing factor associated with DVTwhich is seen in 33 patients in 30.55%. Thrombosis due toorthopaedic trauma is seen eight patients only. Chronic illnessand malignancy was present in 19.44% of patients.Conclusion: It is very important for accurate diagnosis ofDVT to prevent potentially fatal complications like pulmonaryembolism (PE) and pulmonary hypertension. Also it is veryimportant to avoid anticoagulants therapy with associated riskof bleeding in patients of misdiagnosed and negative colourdoppler findings. Because clinical features are nonspecific;hence new strategies were evolved for diagnosing thiscondition.