International Journal of Surgery Science
ISSN / EISSN : 2616-3462 / 2616-3470
Published by: Comprehensive Publications (10.33545)
Total articles ≅ 711
Latest articles in this journal
International Journal of Surgery Science, Volume 5, pp 68-70; https://doi.org/10.33545/surgery.2021.v5.i4b.761
In atypical presentations, ultrasonography may be helpful to confirm the diagnosis of acute generalized peritonitis. Our study aimed to evaluate its accuracy at Albert Royer National Children’s Hospital Centre of Dakar, in Senegal. We conducted a two-year (2018-2020) retrospective cross-sectional study, with an analytical aspect. Fifty-one patients were included in our study. In 56.7% of cases, a radiologist realized the ultrasonography. The sensibility and specificity of ultrasonography for the diagnosis of acute generalized peritonitis were 70 and 75% respectively. Accuracy of diagnosis was reduced proportionally to the operator's experience, ranging from 82% for radiologists, 66% for interns in radiology to 46% for trainees in radiology (p=0,0145). In our environment, the accuracy of ultrasonography for the diagnosis of acute generalized peritonitis is poor, and largely influenced by the operator's experience, which relegates this investigation to the second line, behind clinical suspicion.
International Journal of Surgery Science, Volume 5, pp 83-86; https://doi.org/10.33545/surgery.2021.v5.i4b.765
Background: A clear Understanding of injury patterns, causes and outcome of patients of head injury is essential for establishment of preventive strategies as well as treatment protocols. Such data is lacking in our environment as no local study has been done. The objective of this study is to determine age and sex distribution of head injury cases, etiological factors, indications of surgical interventions, various complications and their management, morbidity and mortality of head injury patients and the risk factors associated with morbidity and mortality. So as to improve management of head injury patients. Methods: This was a prospective study carried out at Dept. of surgery at us tertiary care center over a period of two years from October 2015 to September 2017. Patients who were admitted in wards and ICU of all age groups and of both sexes having head injury were selected for analysis. Results and conclusion: incidence of head injury was more in younger age males, rural population, evening and night time. Adverse outcomes were associated with Alcoholism, poor GCS presence of comorbidities.
International Journal of Surgery Science, Volume 5, pp 91-96; https://doi.org/10.33545/surgery.2021.v5.i4b.767
Introduction: Acute appendicitis, though one of the commonest emergencies in surgical practice, can at times confuse the best of clinicians. Failure of an early diagnosis could lead to progression of the disease process with its attendant morbidity as well as occasional mortality. In spite of the technical advances, diagnosis of acute appendicitis remains a clinical entity. A negative appendectomy rate of 20% has been described in the surgical literature. The aim of the present study was to evaluate the diagnostic accuracy of appendicitis through a comparison of the modified Alvarado score (MAS) and the abdominal ultra-sonogram for diagnosing patients with suspected acute appendicitis.Patients and methods: An analytic and observational study was conducted on 50 patients during a period of 24 months, from October 2017 to September 2019. Patients that were initially suspected of presenting with acute appendicitis that were rule doubt before surgery were eliminated from the study and gynecological and urological diseases, pregnant females, any mass per abdomen and appendicular abscess and ruptured appendix diagnosed Intraoperatively were excluded from study. The variables analyzed were age, surgical result, and score results from the modified Alvarado score and preoperative Ultrasound findings. These were then compared with postoperative histopathology report.Results and discussion: During the study period total 50 patients included in this study, all the patients underwent classical appendicectomy. The mean age of patients is 32.84±6.35 and male to female ratio of 3:2 Correlating the patients’ modified Alvarado score (MAS) with the post-operative histopathological reports, the following observations were made. 5(10%) patients had a Modified Alvarado score of 1 – 4, out of which 3(60%) patients had histopathological evidence of reactive lymphoid hyperplasia and 2(40%) patients were found to be negative for appendicitis. None had a pathological evidence of acute appendicitis in either sex. In 15(30%) patients with MAS of 5-7, 8 (53.33%) patients had histopathological evidence of acute appendicitis; 6(40%) patients had reactive lymphoid hyperplasia and 1(6.66%) patient revealed unremarkable appendix on histopathology. Among the 30 (60%) patients with a modified Alvarado score of more than 7, 26(86.66%) had histopathological evidence of acute appendicitis; 3(10%) patients had reactive lymphoid hyperplasia and 1(3.33%) was unremarkable. All the patients were subjected to ultra-sonogram of the abdomen. Of the 50patients, 41 (82%) had USG findings suggestive of acute appendicitis. In 9 (18%) patients, the appendix did not reveal any features suggestive of acute appendicitis.Conclusion: To conclude acute appendicitis is a common surgical abdominal emergency. Modified Alvarado score is an on invasive, safe diagnostic procedure, which is simple, fast, reliable and repeatable. It can be used in all conditions, without expensive and complicated supportive diagnostic methods. Modified Alvarado score increases the diagnostic certainty of clinical examination in diagnosis of acute appendicitis.
International Journal of Surgery Science, Volume 5, pp 100-102; https://doi.org/10.33545/surgery.2021.v5.i4b.769
Acute necrotizing pancreatitis is a disease with severe prognosis and more mortality as compared to interstitial pancreatitis. A screening test which is readily available for the detection of pancreatic necrosis would aid a lot in the early management of gallstone induced acute necrotizing pancreatitis. This study was conducted in patients of gallstone induced acute pancreatitis presenting to the emergency department of Indira Gandhi medical college, Shimla, Himachal Pradesh. 61 patients were included in this study. Initial blood sugar levels were compared to the occurrence of pancreatic necrosis. We concluded that normal or low blood sugar level reflects absence of necrosis in acute pancreatitis. Therefore, it may be used to rule out the possibility of acute necrotizing pancreatitis. This will help a lot in management of such patients in areas where resources are limited and scarce.
International Journal of Surgery Science, Volume 5, pp 103-105; https://doi.org/10.33545/surgery.2021.v5.i4b.770
Background: According to WHO, Cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, in 2018. Due to recent pandemic of COVID 19 there were limitations of health services in the country. For those patients in whom Surgery is the mainstay of treatment, the delay in the treatment was due to cancellations of elective surgeries as per government regulations and lack of transportation for patients due lockdown and curfew imposed to curtail the pandemic. In the latter half of the initial relaxation of the lockdown, a institutional protocol was framed for all those requiring surgical treatment. All patients were asked to get a RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction) test done from GIIMS hospital, Kalaburagi. RT-PCR negative patients were admitted for surgery and subjected to HRCT Thorax (High-resolution Computer Tomography). This was done to avoid risk to health care workers, patients, and attenders and also screen asymptomatic carriers and false negative RTPCR statusMaterials and methods: This is a Retrospective data based study conducted in department of radiology, Kidwai VTSM Peripheral Cancer Centre, Kalaburagi. HRCT Reports of 100 patients were analyzed by experienced radiologist of the institution.Results: The number of patients under the CO-RADS 1 category was 63 and CO-RADS 2 category was 37, according to CO-RADS classification. The results of RT-PCR and HRCT were compared and there was a 100% positive correlation between RT-PCR and HRCT Thorax.Conclusion: Above study supported the use of HRCT Thorax as a diagnostic tool in preoperative screening of cancer patients for COVID 19, particularly in RT-PCR negative cases.
International Journal of Surgery Science, Volume 5, pp 71-73; https://doi.org/10.33545/surgery.2021.v5.i4b.762
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a life-threatening multi-organ disease that has swept the globe. Patients with COVID-19 are at an increased risk of thromboembolic consequences involving both the venous and arterial systems, according to growing evidence. Thromboembolic events in COVID are more likely among patients hospitalized to the critical care unit, according to research. However, even in ambulatory and moderate cases of COVID infection, some cases have lately been documented with comparable consequences. D-dimer and fibrinogen levels in the lab can help determine the likelihood of developing thrombotic complications in these patients. This case series discusses about three cases which had similar presentations of coagulopathy of the upper limb arteries associated with COVID infection.
International Journal of Surgery Science, Volume 5, pp 26-30; https://doi.org/10.33545/surgery.2021.v5.i4a.757
Aims and Objectives: differences in two methods of inguinal hernia repair in terms of operative time, chronic pain at 3 months and recurrence at 6 months. Materials and Method: This study conducted in the department of Surgery, Indira Gandhi Medical College, Shimla from 1st June 2013 to 31st May 2014 included 40 patients admitted in department with inguinal hernia who were fit for surgery. Patients were randomized to self-fixating/gripping Mesh hernioplasty and Lichenstein tension free/ sutured mesh Hernioplasty groups randomly in groups of 20 each. Results: Self-fixating mesh group was associated with significantly decreased operative time (mean 27 minutes) as compared to sutured mesh hernioplasty (mean 44.7 minutes). However, no significant difference was found in post-operative pain (VAS score), analgesia requirement, chronic pain at 3 months, postoperative hospital stay or recurrence at 6 months in either group.Conclusion: The only benefit of using self-fixating of using self-fixating/self-gripping mesh is decreased operative time.
International Journal of Surgery Science, Volume 5, pp 39-42; https://doi.org/10.33545/surgery.2021.v5.i4a.760
Introduction: The classic intervention for saphenous vein varicosity has been Saphenous femoral junction ligation with stripping. But now endogenous laser ablations are recommended over surgery. Method: This is the retrospective study of 122 patients, conducted for the period of one year in the department of Cardio Thoracic and Vascular Surgery of Bir Hospital, Nepal. Results: Out of 122 cases, 84 were of Endovenous Laser Ablation, 31 cases Ligation and Stripping and 8 cases of sclerotherapy with complete success rate in all group. There was a one case of deep vein injury in Liagtion and Stripping group and one case of skin burn in Endovenous Laser Ablation group, along with other minor injuries. Conclusion: Both group have complete success rate however, hospital stay of patients in Endovenous Laser Ablation group was shorter and reassumed daily activities earlier.
International Journal of Surgery Science, Volume 5, pp 23-25; https://doi.org/10.33545/surgery.2021.v5.i4a.756
Background: Peripheral Arterial Disease (PAD) causes significant health and economic burden.Nice guidelines recommend performing Doppler US (DUS) as the first line in all patients with PAD for whom re-vascularization is being considered. MRA should be performed if further imaging is needed before re-vascularization and CT angiography (CTA) is indicated only if MRA is not tolerated or contraindicated.Some published studies showed superiority of contrast enhanced MRA over conventional diagnostic angiography.On the basis of these guidelines and the published literature diagnostic invasive lower limb angiography should not be routine practice because of the risks and the costs implications. We performed a study to identify the adherence in our unit to these guidelines and the resulting impact on patient safety and service provision costs.Methods: Retrospective data collection in a single large UK tertiary referral centre. Fifty-eight patients who underwent lower limb bypass surgery were included over a time period from June 2015 to June 2016.Results: 75% of the patients (N: 44) had DUS as a first investigation, 29% (N: 17) had CTA or MRA as a second investigation and 39% (N: 23) of the patients had diagnostic angiography preoperatively with an overall complication rate (diagnostic and therapeutic angiography) of 12%.The estimated costs of the angiographies during the one-year period were £28,934 (£1,258 per patient).Conclusion: Significant percentage of the patients going for lower limb bypass surgery are subject to unnecessary risk due to pre-operative diagnostic angiography with an overall increase in service costs. This is unjustified in the view of the current National guidelines and published literature.
International Journal of Surgery Science, Volume 5, pp 31-33; https://doi.org/10.33545/surgery.2021.v5.i4a.758
Aim: To present our clinical experience with gallbladder perforation cases in cases admitted with acute cholecystitis.Methods: Records of 75 patients who received medical andor surgical treatment with the diagnosis of acute cholecystitis in Sri Venkateswara medical college hospital and research centre, Ariyur, Puducherry between November 2020 to August 2021 were reviewed retrospectively. Five (6.6%) of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated.Results: One patient had type I gallbladder perforation, 4 type II gallbladder perforation according to Niemeier’s classification. The patients underwent surgery after administration of intravenous fluids, analgesics and antibiotics after admission.Conclusion: Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.