Abdominal gunshot injury: a prospective study of 63 consecutive patients

From April 1989 through April, 1991, 63 consecutive patients with internal abdominal injuries resulting from firearm trauma were treated by laparotomy in a general surgical unit. Their mean age was 26.35% years. Laparotomy was indicated mostly by the signs of peritoneal irritation. In majority [82.6%] of the cases two or more organs were injured. There was 7.9% mortality rate due to perioperative shock and septicaemia. A significant morbidity resulted from wound sepsis, intra-abdominal abscess, faecal fistula and empyema thoracis. It is concluded that hollow abdominal viscera are the most commonly affected organs following firearm trauma. The morbidity and mortality have a direct relation with the number of injured organs

Early cholecystectomy safe option in acute cholecystitis

This prospective study comprises of 108 patients. Early cholecystectomy was performed on 54 patients. The results were compared with similar number of patients undergoing elective cholecystectomy for symptomatic gall bladder disease. Diagnosis was based on history, clinical examination and ultrasound scan. The diagnostic accuracy of ultrasonography was similar in both groups. The degree of technical difficulty encountered as evaluated by surgeon and post-operative complications were also comparable. Early cholecystectomy was proved to be associated with advantages like avoidance of complications of acute cholecystitis, saves the patient from recurrent painful attacks and shorter duration of treatment. This comparative study revealed that early cholecystectomy performed by an experienced surgeon is a safe and better option in acute cholecystitis

Laparoscopic assisted extracorporeal appendicectomy

Laparoscopic appendicectomy is well recognized and established way of doing appendicectomy. There are different ways of doing this. Most of these employ endoloop or recently, multifire staples which are expensive. A prospective study of twenty five cases of laproscopic assisted appendicectomy is presented in which no endoloop or multifire staples were employed. Procedural details are given. Safety, advantages and disadvantages of the procedure are highlighted

prospective reappraisal of duodenal injuries: Correlation of outcome with organ injury severity [OIS]

A study of 20 consecutive patients with duodenal injuries admitted in a Surgical Unit of Mayo Hospital, Lahore in the year 1993 - 95 is presented. Majority of patients were young [mean age 28.5 years] male [90%]. Penetrating injuries [80%] were far more common than blunt trauma. According to organ injury scale [OIS], eight patients had Grade I and II injuries, twelve had Grade III and IVinjuries. Eighty five percent of patients had associated injuries to other organs. Primary duodenal repair [60%], duodenal repair with gastro jejunostomy [30%], resection of duodenum with duodenojejunal end to end anastomosis [5%], and pyloric exclusion with gastro jejunostomy [5%] were the procedures carried out. Morbidity in this series was 85% and mortality 20%