Surgical management of carcinoma of caecum

To study the various aspects of caecal carcinoma as age, sex, clinical presentation and diagnosis. This retrospective study was conducted in Surgical Units of Nishtar Hospital, Multan during the period from January 1997 to December 2000. A total of 60 patients were included in the study. There were 45 cases of males and only 15 cases of females. Male to female ratio was 4:1. The age range was 30-80 years. Most of the patients were between the ages 45-65 years. The youngest patient was 30 years old and the oldest patient was 80 years old. Both were males. The average age was 55 years. Mass in RIF was found in 42 patients, acute appendicitis was seen in 6 patients and intestinal obstruction was present in 12 cases. Right hemicolectomy with primary ileo-transverse anastomosis was done in 42 cases. Surgery is the mainstay in the treatment of carcinoma of caecum. Thus right hemicolectomy with primary ileo-transverse anastomosis is a safe procedure in fit patients even in emergency

Surgical Management of Blunt Abdominal Trauma

To evaluate and compare the usefulness and limitations of diagnostic peritoneal lavage and ultrasonography in patients with blunt abdominal trauma. The study was conducted Nishtar Hospital, Multan on 100 cases presented with BAT having equivocal abdominal findings during one year i.e. March 2005 to February 2006. It was a prospective comparative study. Main age group involved in accidents and BAT was between 40 to 60 years Male to female ration was 5:1 Liver was main organ injured in most cases of BAT. It was observed that DPL was 100% sensitive and 91.3% specific while USG of abdomen was 88.9% sensitive and 100% specific. DPL. is more sensitive while abdominal USG is more specific. Both are complementary to each other

Duration between perforation and operation affecting the prognosis duodenal ulcer perforation

To describe the effect of perforation-operation interval on the prognosis of perforated duodenal ulcer. This descriptive study was conducted in surgical units of Nishtar Hospital, Multan during the period of two year from January 2004 to December 2005. There were 100 patients in study. All patients were divided into three groups according to perforation operation interval. In 58% of patients surgery was performed after 24 hours. Overall mortality of 16% in 50 patients was observed who underwent surgery. Mortality occurred only in group-B and C. Increased interval between perforation and operation increases stay in hospital. Number of complications in patients presenting with delay were much more than in patients presenting early. Morbidity rises with delay. Patients with perforated duodenal ulcers should he operated on as soon as possible. Simple closure of perforation is simple and safe with relativity low mortality and short stay in hospital

Management of fistula-in-ano; a common clinical problem

Study design A prospective study of 54 patients [age ranging from 18-54 years] operated for perianal fistula. Place: First Surgical Unit Nishtar Hospital Multan. Duration: January 2000 to July 2001. To determine the incidence of low or high anal fistula, recurrence rate following surgery and effect of surgery as well as effect of previous procedures on the incontinence. Material and methods: The fifty four patients [54] were subdivided into two groups' i.e. low and high anal fistulae and were operated by laying open technique [fistulotomy] for low fistulae and by two-stage fistulotomy, seton "cut-through technique and Re-routing of the tract for high fistulae. Patients were followed to see the incidence of recurrence, effect of surgery on continence as well as effect of previous surgery on continence. Overall recurrence was only 4.44% for low fistulae and 11.11% for high fistula in-ano. Minor incontinence was observed only following surgery for high variety. No such complication occurred in low variety. Low fistulae can be laid open with minimal loss of sphincter muscle but as for as the high variety is concerned it is safer to place a seton or stage the procedure