Role of nasogastric intubation after small bowel anastomosis

To determine advantages and disadvantages of postoperative nasogastric intubation after small bowel anastomosis. Quasi experimental. Surgical Unit-1, Holy Family Hospital, Rawalpindi, from December 2003 to December 2006. A total of 112 patients, undergoing small bowel anastomosis were equally divided in group I and II with and without postoperative nasogastric intubation respectively. Variables compared were number of patients having episodes of vomiting, change in abdominal girth, the time for onset of bowel sounds, time to begin per oral fluids, length of hospitalization and postoperative complications. In group-I, nasogastric tube was removed on an average after 3.1 days. Average postoperative nasogastric output was 357, 154 and 64 ml/day for day 1, 2 and 3 respectively. There was no statistically significant difference between two groups in abdominal girth before and after operation, frequency of vomiting, time taken for onset of bowel sounds and start of oral sips after operation, frequency of wound infection, anastomotic leak and mortality [p>0.05]. Length of postoperative hospital stay and frequency of postoperative respiratory complications were more in group-l as compared to group-II [p<0.05]. Nasogastric decompression does not provide added advantage after small bowel anastomosis

Perforated duodenal ulcer; frequency during the holy month of Ramadan

Objective: To compare the frequency of patients presenting with perforated duodenal ulcer during holy month of Ramadan with those presenting during the rest of the year. To assess the risk factors such as smoking, non-steroidal anti inflammatory drugs usage and a history of acid peptic disease. To assess the age groups and gender of patients. Study Design: It was a descriptive study. Period: Three years from Jan 2001 to Dec 2003

Setting: Surgical units of Holy Family and Rawalpindi General Hospitals

Materials and Methods: A total of 133 patients presenting during this three years period were managed surgically after resuscitation in the emergency rooms of both the hospitals. History findings were recorded on a specially designed proforma for this study

Results: 36% of all the patients presented during the holy month of Ramadan alone as compared to 64% during the rest of the year. 46% of all the patients were smokers, whereas 64% of the patients had a previous history of acid peptic disease. 54% of the patients were in the 20 to 40 years age group and the male to female ratio was 5:1

Conclusions: This study clearly showed the increased frequency of perforated duodenal ulcers during the holy month of Ramadan and stresses on the need of precautions specially for smokers, non-steroidal anti inflammatory drugs users and patients with the history of acid peptic disease during this month