CLINICAL STUDY OF MISCELLANEOUS CAUSES OF INTESTINAL OBSTRUCTION

2021-12-05T14:53:03+0530

Introduction- Acute intestinal obstruction is one of the most common surgical emergencies.

Miscellaneous causes of bowel obstruction needs to be evaluated thoroughly.

Aims and Objectives- Pre- operative diagnosis (Predicting rare differential diagnosis as causes) of intestinal obstruction and timely intervention to reduce postoperative morbidity and mortality

Methods - A retrospective observational study of 124 cases of intestinal obstruction from June 2018 to November 2020 by examining previous clinical records in terms of Clinical presentations, Laboratory investigations , Radiological investigations, Operative procedures, and Post operative outcomes was done. Out of 124 cases 40 cases were managed conservatively and were excluded from study. Out of remaining 84 cases 20 cases presented with unusual causes of intestinal obstruction on laparotomy.

Results- 20 rare causes of intestinal obstruction in our study were namely 2 Paraduodenal hernia, 2 foreign body(phytobezoars) obstruction of ileum, 1 - obstruction by worm infestation , 6 cases of volvulus ,1 gall stone ileus , 1 meconium plug syndrome ,and ,1 case of obstructed obturator hernia,1 case of Meckel’s Diverticulum with Ileocolic Intussusception,5 with varied presentation of abdominal koch’s.

Conclusion- It is important to consider these rare causes of intestinal obstruction as an important treatable cause of obstruction .

A Retrospective Comparative Analytical Study Between Open And Laparoscopic Cholecystectomy

2021-12-05T14:52:37+0530

Background:- Gall stone disease is very common in Indian scenario and with the introduction of Laparoscopic Surgery in surgical domain there is change in preference of patients for Laparoscopic Cholecystectomy.

AIM:-The aim of this study was to analyze between conventional cholecystectomy and laparoscopic cholecystectomy with respect to selection of patients, operative difficulties, duration of surgery, operative complications, post-operative analgesia, post-operative hospital stay, morbidity and mortality, and lastly patients feedback after surgery.

Design and Duration :- Retrospective comparative analytical study was conducted from January 2016 to June 2017.

Place :-Surgical Unit II, Dep’t of Surgery, at ESI-PGIMSR & ESIC Medical College, Joka , Kolkata-104, West Bengal.

Patients.:- Study was conducted on 200 patients of which 100 patients were subjected to open cholecystectomy and other 100 patients were subjected to Laparoscopic Cholecystectomy by draw a lot method

Methodology:-Patients were admitted through SOPD, thoroughly assessed by necessary investigations and PAC fitness, valid informed consent for the particular procedure was obtained after pros and cons of the said procedure were explained in details to the patients and their party.

Results :-In the present study it is found that the total number of gall stone patient reported in the dept female patients are statistically more in comparison to male patients.It is also observed that n the operation time for Laparoscopic Cholecystectomy was significantly less than the Open cholecystectomy procedure.

Most important observation of this study is that the duration of post-operative pain and analgesia required were significantly less in Laparoscopic cholecystectomy group as compared to open cholecystectomy and the duration of hospital stay of the patients who underwent Laparoscopic surgery had hospital stay less than 4 days while those who underwent open surgery had more than 7 days of stay.

In the present study it is also found that 1% of patients who underwent open cholecystectomy had bleeding and 8 % with wound infection. Where as in Laparoscopic surgery the rate of complication was found to be 3 % for bleeding which was minimal and 3 % for wound infection. Conversion rate in Literature in Laparoscopic Cholecystectomy ranges from 3% to 15% in well trained hands. In our series it amounts to 4% in spite of being a teaching Institute.

Conclusion :- Themain advantage of Laparoscopic Cholecystectomy were reduced post-operative pain and less analgesic intake, reduced Hospital stay, less wound complications, rapid recovery, and early return to normal work. However Open Cholecystectomy is the preferred method in case of difficult Cholecystectomy.

Surgical Review: International Journal of Surgery, Trauma and Orthopedics

CLINICAL STUDY OF MISCELLANEOUS CAUSES OF INTESTINAL OBSTRUCTION

A Retrospective Comparative Analytical Study Between Open And Laparoscopic Cholecystectomy