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Background: Perforation peritonitis is a commonly encountered surgical emergency and it is defined as inflammation of the serosal membrane that lines the abdominal cavity and the visceral organs. The objective of this study is to predict a correlation between post-operative outcomes in perforation peritonitis patients with reference to the history of nonsteroidal anti-inflammatory drugs (NSAIDs) use. Materials and Methods: A total of 209 cases were studied with hollow viscous perforation peritonitis admitted in the surgical wards in Sanjay Gandhi Memorial Hospital associated with S. S. Medical College, Rewa (M.P.), India, in the period from June 1, 2018, to May 31, 2019. All necessary investigations were carried out. X-ray, ultrasonography abdomen, and blood investigations were done. Patient underwent emergency exploratory laparotomy and a careful record of pre-operative and post-operative findings was made and was carefully filled in the pro forma. All the patients were advised to attend surgical OPD for follow-up. Results: Most of the patients (73.2%) of perforation peritonitis had a history of NSAID intake, out of which 81.6% recovered from the disease while mortality rate in perforation peritonitis associated with NSAID use was found to be 18.4%. Those patients with no history of NSAID use (26.8%) had a mortality rate of 9% while 91% of patients of perforation peritonitis were recovered from the disease. Conclusion: In this study, it is concluded that the outcome of the patients of the perforation peritonitis is not dependent on the history of NSAIDs use, but NSAIDs abuse is one of the etiological factors in the pathogenesis of the perforation peritonitis
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Introduction: Computed tomography (CT) scan is an accurate tool for the detection of injuries in a trauma setting and is able to find the injuries that were occult in chest X-ray (CXR). In past years, the utility of CT scan was limited to severe trauma injuries but now is used in less severely injured trauma patients. The study aimed to compare the efficacy of CXR and chest CT scans in patients with chest trauma. Materials and Methods: The present study was conducted in the Department of Surgery of Medical Institute. For the study, we prospectively view the previous medical records of the patients who were admitted in our surgical ward for blunt chest trauma and received both CXR and high resolution CT chest scans. A total of 95 patients were included in the study. Data regarding the study were collected. Results: Out of 95 patients, 79 were males and 16 females. The mean age of the patients was 32.42 years ranging from 2 to 90 years. The most common cause for blunt trauma to the chest according to our results was a road traffic accident. We observed that CT scan is more accurate as compared to CXR in the detection of certain cases such as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax. Conclusion: Chest CT scan is highly sensitive in the detection of thoracic injuries following blunt chest trauma. In day-to-day practice, CT scan is better in visualizing as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax
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Background: Facial trauma is the most common trauma worldwide and more than 30% of the trauma cases suffer from fractured maxillofacial (MF) skeleton. MF region involves soft and hard tissues forming the face extending from frontal bone superiorly to the mandible inferiorly. The face being the most exposed part of the body is particularly prone to trauma. The primary cause of MF fractures throughout the world is road traffic accidents (RTAs) and assaults. In India, in spite of the great impact of MF traumatic injuries on the patient’s quality of life, there is inadequate information about the epidemiological characteristics of this problem. Aims: This study aims to study the incidence, patterns of injury, and different factors contributing to morbidity and mortality in MF injuries. Materials and Methods: All cases of MF injuries irrespective of the age and sex admitted through casualty or transferred from other departments or reported in opd during June 1, 2016–May 31, 2017. Detailed history and physical findings were recorded depending on the combination of fractures sustained. As in any trauma situation, initially addressing of all life-threatening injuries by following the advanced trauma life support protocol. Patients were managed with appropriate radiological investigations followed by either conservative or suitable operative procedures. Results: The male-female ratio of MF fractures was 6.5:1. 80% of MF fractures were caused by RTA. Mandible was most commonly involved isolated bone fracture in the present study (44.39%). The most common fracture seen was midface fracture, i.e., 50% of total MF fractures. 60% of mandibular fracture managed by closed reduction, 37.89% by open reduction, and rest 2.1% by conservative means. Midface and upper face fracture, 38.65% fracture managed by closed reduction, 47.90% by open reduction, and rest 13.45% by conservative means. Overall, mortality was 6%. Conclusion: RTAs remain the biggest etiological factor of MF fractures. There is higher incidence of fractures in men than women. There seems to be an urgent need for enhanced monitoring and regulation on motor vehicles to reduce the morbidity and mortality associated with RTAs. It is hoped that epidemiological surveys such as the one presented here will help the healthcare professions and policymakers in planning future programs of prevention and treatment
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Background and Objective: Diagnostic laparoscopy is an emerging tool in diagnosis of chronic non-specific abdominal pain, the diagnosis of which remains uncertain despite employing the requisite laboratory and non-invasive imaging investigations. The aim of our study was to evaluate the role of diagnostic laparoscopy in chronic abdominal pain and its correlation with clinical and radiological finding. Materials and Methods: Our study was carried out on 48 patients admitted in surgical wards. All patients having chronic abdominal pain were included in the study, and patients with acute abdominal pain, with an uncorrectable coagulopathy, or uncorrectable hypercapnia and pregnant females were excluded from the study. Detailed history, examination, baseline blood, and radiological investigations were done to reach to diagnosis. Patients were subjected to diagnostic laparoscopy, and the necessary surgical therapeutic interventions during laparoscopy were employed as per the etiology after taking informed written consent. The usefulness of laparoscopy to confirm the diagnosis and clinical management of these patients of chronic abdominal pain was evaluated. Result: The incidence of chronic abdominal pain was almost equal in both genders. Peak incidence was seen in the age group of 31–40 years. Koch’s abdomen was the most common finding during laparoscopy followed by chronic/recurrent appendicitis. Definitive diagnosis was made in 43 patients, and 38 patients had shown resolution of pain after diagnostic laparoscopy. Conclusion: Laparoscopy offers a definitive diagnosis in a large number of patients of chronic abdominal pain and also provides therapeutic intervention. An early resort to laparoscopy can resolve the diagnostic dilemma and early treatment can be instituted.
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Introduction: Emergency laparotomy is a common intra-abdominal emergency procedure. The incidence of surgical site infection (SSI) generally recognized more as compared to the routine. SSI is associated with significant precipitating factors related to patient, surgeon, and hospital. Related multiple comorbidities are also a major factor. Early identification and management of SSI are related early recovery. Materials and Methods: A total of 250 cases were selected out of 271 patients who got admitted in the surgical ward, and underwent emergency laparotomy during the period of study were included in the study irrespective of the age and sex. Postoperatively patients were regularly monitored and treated accordingly. Post-operative SSI was recorded, and incidence was calculated. Results: SSI was noted in 66 patients out of 250, affected male was 28.1% and female 20.6%, maximum incidence noted in age group 41–50 years was 52.2%, and more number of SSI was noted in case of ileostomy for ileal perforation 43.3%. Main isolated organism was Escherichia coli. Conclusions: SSI is a major complication of emergency surgeries. An effect to reduce the rate of SSI should be our aim and for this proper surveillance regarding wound infection and its causative factors should be studied regularly and effective steps should be taken to reduce the rate of SSI