Role of deliberate creation of control enterocutaneous fistula in patients of abdominal tuberculosis with perforation of small bowel and matted small intestine

To study the results after forming the controlled enterocutaneous fistula in the patient of abdominal tuberculosis with matted and perforated small bowel. Design, place and duration of study This study based on therapeutic trial and conducted in one and half years from january1999 to june2001 at Mayo Hospital, Lahore. All these 20 patients either operated in emergency or on elective list were malnourished, toxic and their operative findings were almost the same, these patients had extensively matted, friable and perforated gut. In these patients it was technically not possible to perform some definite procedure like right haemecolectomy or ileostomy with out increasing the morbidity or mortality. Under these circumstances, minimal surgical procedure which can be life saving is to oppose the anterior abdominal wall to the perforation and thus create a controlled enterocutaneous fistula. In 11 patients fistula closed on its own and in eight patients fistula remained patient and needed re-exploration and repair. This new method of treatment has yielded excellent results. We were able to cure the disease with no mortality. It is recommended that in cases of TB peritonitis with perforation and matted gut making of a controlled enterocutaneous fistula saves the life of the patient

Pattern of upper gastrointestinal bleeding at Rahim Yar Khan

It is a Prospective Observational case series. The study was conducted at Sheikh Zayed Hospital/Hamza Medicare Rahim Yar Khan, between January 1997 and December 2004. Patients and Methods; Consecutive 892 patients presenting with significant gastrointestinal bleeding, between January 1997 and December 2004 were recruited in this study. Source of active bleeding was defined by endoscopy. Esophageal variceal bleed was the main finding 580, followed by gastric erosions 133 patients, Esophageal Ulcer 65, duodenal ulcer 61, bleeding gastric ulcer [26], Mallory Weiss Tear 21 and Osler Weber Rendu Syndrome/AV malformation 06 only. Esophageal varices are-real problem within our area but the scope has changed in the western world. Variations in disease pattern from time to time require the periodic studies to be aware of the current underlying mechanism of the ailments in the area of work. Total reliance on literature may consume local resources