Résumé
Background: Appendicectomy is one of the most common surgical procedures performed in emergency surgery. Despite this, there is still lack of consensus about the most appropriate technique for appendicectomy. In this longitudinal analysis, we aimed to compare the outcomes of laparoscopic appendicectomy (LA) and the conventional technique or open appendicectomy (OA) in the treatment of acute appendicitis.Methods: A non-randomized longitudinal comparative study was conducted in NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India. From November 2017 to October 2019, 53 patients underwent OA and 59 underwent LA, making a total number of patients included in this study to be 112 (n). The two groups were compared for operative time, length of hospital stay, postoperative pain, post-operative ileus and complication rate.Results: Laparoscopic appendicectomy was associated with a shorter hospital stay (4.34±1.37 days in LA and 5.09±1.71 days in OA, p<0.01), with a lower post operative pain score [VAS] (2.93±0.80 in LA and 4.62±0.92 in OA, p<0.001). Operative time was shorter in the open group (42.70±12.05 min in OA and 43.39±16.59 in LA). Complications were lesser in the LA group with a significantly lower incidence of wound infection (3.4% in LA and 13.2% in OA).Conclusions: Laparoscopic approach is safe and efficient in appendicectomy and it provides clinically advantages over open method (shorter hospital stays, lower post op pain, early food tolerance, earlier return to work and lesser wound infection) against only marginally longer operative time.
Résumé
Ingested foreign bodies are commonly encountered in clinical practice, especially in children. Till now, no case has been reported in the literature where a small intestinal obstruction was produced as a result of foreign body (areca nut) ingestion. We report a case of a 30-year-old female clinically presented as an acute intestinal obstruction of 4 days duration. Her plain X-ray abdomen showed multiple small intestinal fluid levels. Abdominal ultrasound showed dilated loops of small intestine. Contrast-enhanced computed tomography abdomen showed an intraluminal non-enhancing lesion near ileocecal junction. Exploratory laparotomy revealed 3 cm×2.5 cm× 2.5 cm rounded foreign body (swollen areca nut) causing an intestinal obstruction which was removed by enterotomy. There was no ileal stricture or diverticulum noted. Post-operative period was uneventful
Résumé
A gastric lipoma is a rare entity and accounts for 2–3% of all benign gastric lesions. It is a diagnostic challenge. We present a case of a 35-year-old male who presented with intermittent attacks of pain in abdomen, vomiting, and dyspepsia. Upper gastrointestinal (GI) endoscopy showed a polypoidal lesion in the antrum prolapsing into the duodenum. Contrast-enhanced computed tomography abdomen showed a 5 cm × 3 cm × 3 cm, oval, smooth fat density lesion in the posterior wall of the antrum near the pylorus confirming the diagnosis of submucosal gastric lipoma with gastric outlet obstruction. Laparoscopic gastrostomy with removal of submucosal lipoma was done with uneventful post-operative recovery. The patient gained 10 kg weight after 18 months of follow-up without any GI symptoms. In conclusion, gastric lipomas are rare benign tumors of the stomach which may mimic malignancy.