ABSTRACT
Acute appendicitis is one of the commonest abdominal emergency encountered by a general surgeon. Understanding the surgical pathology is pivotal in identifying the stage of disease at which the patient presents for better correlation of clinical features, laboratory and imaging reports. Various scoring systems enhance and aid this process. Imaging confirms the diagnosis. Early diagnosis is essential to prevent complications. Surgery is the mainstay of treatment. Appendicitis may present in various forms in different clinical settings. A uniform approach to presentations may not always yield good results. Though appendectomy is the mainstay of treatment yet a tailor made surgical plan needs to be developed after holistic evaluation of the patient. The article discusses the differential surgical approach based on the etiopathogenesis, diagnosis and variable clinical presentations.
ABSTRACT
Epidermoid cyst is one of the commonest cutaneous swelling treated by a general surgeon. It is usually misnamed as a sebaceous cyst. Understanding the anatomical origin and pathogenesis of the cyst is pivotal for diagnosis and successful treatment. The etiopathogenesis, clinical features and surgical approach is presented in this paper.
ABSTRACT
Background: Umbilical hernia is one of the most commonly encountered hernia in surgical practice. A variety of repairs have been tried our ranging from open to laparoscopic. However controversy still persists as to which type of repair is the gold standard for umbilical hernia. Open technique comprises of the onlay mesh repair which is known to develop a variety of complications. Even laparoscopic approach also has failure rates as well as local complications. The aim of the study was to evaluate the surgical outcome of open retro rectus mesh repair for adult umbilical hernias.Methods: 50 consecutive cases of umbilical hernia were repaired by open technique with retro rectus placement of mesh.Results: There were no local complications or any recurrence in any of the fifty patients.Conclusions: Retro rectus placement of mesh in open repair of umbilical hernia in adults is a safe and effective modality of treatment.
ABSTRACT
Abdominal tuberculosis is one of the most challenging forms of extra pulmonary tuberculosis. The diagnosis of the disease itself poses the greatest challenge due to the variability of presentation. Clinical presentations in various forms with conflicting results on a multitude of haematological, immunological and radiological tests causes a lot of confusion in interpreting and correlating the symptoms to arrive at a diagnosis. This adds to the perplexity in surgical management of this complex disease especially in an era where AIDS has added to the problems. Having arrived at a diagnosis, chemotherapy is the mainstay of treatment. Surgery is indicated when the response to medical therapy is poor or complications supervene. Deciding the optimum procedure is again a major issue. Understanding the pathophysiology therefore is pivotal in making a value decision. The article briefly outlines the approach to this surgical perplexity.