Surgical Review: International Journal of Surgery, Trauma and Orthopedics

Clinicopathological features of Pseudocyst Pancreas and its Management: A Prospective and Retrospective Study

2021-01-06T07:14:51+0530

Background: Revised Atlanta Classification has veered a change in our understanding of pseudocyst pancreas which mandates renewed inquiry into pseudocysts defined as per new criteria. The present study provides an overview of experience with Pseudocyst Pancreas for over a decade.

Methodology: 100 cases of pseudocysts diagnosed over the last 10 years at GMC, Bhopal, conforming to the present definition were reviewed. Cysts with the inhomogeneous collection, debris, necrosis, or any other non-liquid component, specifically in those diagnosed before 2012 were excluded. Relevant data were analyzed.

Results: The majority were male (85%) in the age group of 40-50 years with alcohol-induced chronic pancreatitis (77%) being the most frequent etiology. Abdominal pain (40%), lump (30%), and abdominal tenderness (59%) were common at presentation. 58% were in the Head of the pancreas, 29% in the Neck and Body, and 13% in the Tail and surrounding areas. Mean cyst diameter was 8.6cm and volume 252cc. 85% were managed surgically and 40% of those managed conservatively also needed surgical intervention eventually due to complications. History of chronic alcoholic pancreatitis, the large size of the cyst (≥6cm and ≥60cc), and communication with the main pancreatic duct were highly predictive of surgical intervention.

Conclusion: Radiological characteristics along with the clinical picture may suggest appropriate intervention. Surgery remains the principal modality of treatment, with high success rates.

Study of treatment for distal end radial fractures by open reduction and internal fixation with volar locking compression plates

2021-01-08T05:29:14+0530

Introduction: For dorsally displaced lower end radius fractures percutaneous pinning fixation and in some studies fragment specific fixation shows their advantages. For volarly displaced fractures volarly plate fixation traditionally showed good results. The volar locking plates with their inheritance ability to provide absolute stability are attractive for their advantages.

Objective: To assess the functional outcome of treating the distal end radius fractures with the use of volar locking compression plates. Materials and methods: Study of a total of 30 patients was conducted in the department of orthopedics at G K General Hospital, Bhuj, Gujarat. All 30 patients with closed fractures were included in the study. All patients were treated with open reduction and internal fixation with the use of a volar locking compression plate. The patients were followed up at one, two, three, and up to six months. Mayo wrist scoring system was used to assess final functional outcomes of treatment.

Results: At the final functional assessment, as per mayo wrist scoring out of a total of 30 patients, 17 of them achieved excellent, 7 achieved good outcomes, with 5 patients exhibiting fair results and one patient had the collapse of fixation at the 3-month review. No, any patient had diminution of functional outcome. On radiological assessment, 70% of patients had callus formation and no clear fracture line was seen, 18% had callus formation but a visible fracture line was present and 12% of patients had clear visible fracture line up to final follow up.

Conclusion: Open reduction and internal fixation with volar locking compression plating is a safe and effective treatment for unstable especially volarly displaced fractures of distal end radius with satisfactory functional outcome.

Laparoscopic management of rare “ H type” duplication of gall bladder

2021-01-06T06:58:16+0530

A duplicated gallbladder is a rare congenital anomaly with an incidence of 1:4000 live births. They can remain asymptomatic and identified incidentally or present as acute cholecystitis, empyema, torsion, cholecystoenteric fistula, Gall bladder lump, or carcinoma. Here the current case is about discussing a case of a 25-year-old female who presented with symptomatic gallstone disease with a duplicated gallbladder having multiple stones in both the gallbladders. MRCP performed preoperatively revealed Y type duplication (double Gall bladder with common cystic duct). Laparoscopic cholecystectomy was performed and it finally revealed H type duplication (double Gall bladder with separate cystic ducts for each Gall Bladder).