RESUMO
Objective: to determine the clinical spectrum and surgical outcome of gastro-intestinal tuberculosis
Study design: descriptive case series
Place and Duration of study: department of General surgery ward 3 Jinnah Postgraduate Medical Center [JPMC] Karachi, from June 2010 - July 2015
Methodology: all patients who were diagnosed as cases of gastrointestinal tuberculosis and underwent operative procedures were included. Data was collected on a structured proforma. The variables collected included age of the patients, gender, clinical presentation, surgical procedures performed and outcome
Results: a total of 100 patients were managed. There were 67 female and 33 male patients. Female to male ratio was 2:1. The minimum age was 13 year and maximum 50 year with the mean age of 32 year. Apart from the constitutional symptoms like nausea, vomiting and low grade fever, abdominal pain was the commonest presentation. Eighty-eight patients were operated. End ileostomy, limited right hemicolectomy and resection anastomosis with primary repair were the commonly performed procedures. Two patients developed enterocutaneous fistulae. Five patients presented with septic shock and died
Conclusion: intestinal TB had varied presentation. It was found more frequently in females. Fever and weight loss were common presentations. High index of suspicion must be exercised in making a diagnosis
RESUMO
Objective: To compare the outcomes in terms of healing after fistulotomy and fistulectomy for low lying fistulae in ano
Study design: Cross sectional analytic
Place and Duration of study: Department of Surgery, Surgical Unit I, Jinnah Postgraduate Medical Centre Karachi, from June 2013 to May 2015
Methodology: Patients of both genders between 12 to 60 year of age with clinical diagnosis of fistula in ano were included in the study. Pain was assessed on visual and analog scale [VAS] Hospital stay was also recorded. All were followed for four week for any complications
Results: During the study period 120 patients were enrolled. Out of these 60 patients had fistulotomy and 60 underwent fistulectomy for fistula in ano. Male predominated with male to female ratio of 3:1. Swelling [86.6%], discharge [37%] and itching [27%] were the common symptoms. The mean duration of hospital stay was 3 +/- 1 day. Postoperative wound healing and pain assessed by VAS, were high in fistulectomy group. All patients recovered during follow up except one who continued to complain incontinence from fistulectomy group
Conclusion: Fistulotomy yielded better results as compared to fistulectomy for the treatment with low fistula in ano