ABSTRACT
BACKGROUND: Blunt abdominal trauma is regularly encountered in the emergency department. The aim of the study is to determine the validity of assessment with sonography for trauma (FAST) scans in the evaluation of BAT in comparison to Computed tomogram/Exploratory laparotomy (CT/FLAP). METHODS: This cross-sectional study was carried out at Ayub Teaching Hospital Abbottabad from January 2010 to December 2011. FAST was performed as part of the primary or secondary survey of the trauma patient in the emergency department in all patients with suspected blunt abdominal trauma. All of them also underwent either CT or ELAP depending on their clinical condition. The validity of FAST scan in comparison to CT/ELAP was documented. RESULTS: Our study included 100 patients with suspected blunt abdominal trauma. The mean age was 3 1.52 ± 16.79 years with 88% males. Road traffic accidents accounted for 80% cases and 20% were due to fall. Seventy percent were hemodynamically stable and 30% were unstable. Haemodynamically unstable patients had significantly more positive FAST scans and more positive CTIELAP (p < 0.05). Of the total, 52% had positive CTIELAP and 54% had positive FAST scan. Majority (28%) had splenic injury. A positive scan had a statistically significant probability of a confirmed blunt abdominal trauma on CT/ELAP; p = O.OO, OR = 8.095, 95% CI = 3.3-19.8. FAST scan had a sensitivity, specificity, positive predictive value and negative predictive value of 76.92%, 70.83%, 74.07% and 73.9% respectively. CONCLUSION: FAST scan had lesser accuracy as compared to previously published local and international data. More work is required before it can be routinely utilized to triage the blunt abdominal trauma patients to laparotomy.
Subject(s)
Abdominal Injuries/diagnostic imaging , Wounds, Nonpenetrating/diagnostic imaging , Abdominal Injuries/surgery , Adolescent , Adult , Aged , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Laparotomy , Male , Middle Aged , Pakistan , Predictive Value of Tests , Reproducibility of Results , Tomography, X-Ray Computed , Ultrasonography , Wounds, Nonpenetrating/surgery , Young AdultABSTRACT
BACKGROUND: The present study was conducted to evaluate the usefulness and safety of the nonpowder surgical glove for extraction of the gallbladder in laparoscopic cholecystectomy. METHODS: The study was carried out in Capital Hospital Islamabad and in a private hospital. The duration of study was from March 2009 to March 2012. This was an observational study carried out in 492 patients who underwent laparoscopic cholecystectomy using the surgical glove for extraction of the gallbladder and compared with the conventional method of gall bladder removal in two hospitals were analyzed. The operative findings, port site infection and co morbid conditions were evaluated. RESULTS: Postoperative wound infection was found in 27 (5.48%) of 492 cases. Umbilical port infection was found in 26 (5.28%) of cases in which gall bladder was removed without endogloves and only one case (0.2%) had infection when gall bladder was removed with the endogloves. Wound infection was more in acute cholecystitis (25.9%) and empyema of Gall Bladder (44.4%). Among the co morbid conditions, diabetes mellitus has got higher frequency of wound infection (44%). CONCLUSION: The use of the surgical glove for extraction of the gallbladder is safe, cheap, simple and potentially reduces significant morbidity. Its routine use at laparoscopic cholecystectomy is mandatory in all cases.
