ABSTRACT
The COVID-19 pandemic has affected working patterns of all emergency and regular surgical services. We report a case of emergency surgery amid this ongoing pandemic, in a suspected COVID-19 patient with D1 (duodenal) perforation. We did not wait for the real time polymerase chain reaction (RT-PCR) report for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to come, and proceeded with surgery with all safety protocols. We intend not to delay, for the better outcome of patient’s condition, the life-saving response alike we follow routinely. The pandemic scenario is expected to sustain for longer time. We assume, patients requiring acute care surgery with COVID-19 like symptoms (suspected or confirmed), should definitely be proceeded with surgery as earliest, following all safety protocols, and prevent undue and added morbidity and mortality during this pandemic crisis.
ABSTRACT
The surgical management of an appendicular lump remains controversial. With the revolution and advancement of laparoscopic instrumentation and technical learning curve, it is possible to remove an inflamed appendix in presence of lump. This retrospective study was performed between August 2018 and August 2019 in AIIMS Raipur, 86 patients were treated for appendicitis laparoscopically, in these 14 patients had appendicular lump at the time of admission. 12 patients (total 14; 2 patients were excluded) underwent laparoscopic intervention for appendicular lump. Average operative time were 90 minutes. Average post-operative hospital stay were 5 days. Post-operative complications were seen in 2 patients (surgical site infection). In histopathology report, appendicular inflammation suggestive of appendicitis were present in all operated cases. We conclude, early laparoscopic appendectomy confirms the diagnosis. It is safe and feasible in patients with appendicular lump. It reduces the treatment cost, early recovery and satisfactory overall outcome.