Résumé
Pulmonary alveolar microlithiasis is an uncommon infiltrative pulmonary disease characterized by deposition of microliths in the alveoli. We present the case of a young adult with complaints of shortness of breath on exertion. Chest radiograph showed innumerable small, dense nodules, diffusely involving both the lungs - predominantly in the lower zones. High-resolution CT scan illustrated widespread intra-alveolar microliths, diffuse ground-glass attenuation areas, septal thickening, and black pleural lines - predominantly in the basal regions. Transbronchial biopsy confirmed the diagnosis
Résumé
To evaluate relative frequency, reasons, avoidable responsible factors and outcomes of relaparotomy. Observational case series study. Department of Surgery Unit III BVH Bahawalpur. From 01-9-2009 to 31-8-2010. All the patients who presented in surgical outdoor, indoor and casualty department with severe intra-abdominal pathologies after primary laparotomies referred from low level, secondary care and tertiary care hospital and underwent relaparotomy electively or on demand were included in the study. Retrospectively their demographic characteristics, initial diagnosis with surgical information of primary laparotomy, factors and outcomes after relaparotomies were analyzed statistically. A total 54 patients were included in the study with male to female ratio of 1:2. Mean age of the study group was 30.91 +/- 12.5 years. Relative frequency of relaparotomy was 5.6%. Common center of referral was low level hospital 66.7%. Most common indication of relaparotomy was peritonitis in 52%. Most common complication of relaparotomy was wound infection 74%. Avoidable factors responsible for relaparotomies were found to be surgery at low level hospitals [77.3%] and by nonqualified surgeons [72.1%]. The rate of relaparotomy is very high because of unsupervised primary surgery in institutions and surgery by unqualified operators in private sector. Many of these are avoidable. In addition to decreasing the complication rate, primary surgery performed at tertiary care hospitals would decrease need for patients to undergo re-exploration