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http://www.webmedcentral.com/images/Header_Logo.giftext/html2010-11-16T18:15:16+01:00http://www.webmedcentral.com/Dr. Karthikeyan SelvarajuA Rare Case Of Isolated Blunt Traumatic Diaphragmatic Rupture
http://www.webmedcentral.com/article_view/1183
Traumatic diaphragmatic rupture (TDR) is a recognized consequence of high velocity blunt trauma to the abdomen usually a result of motor vehicle accident (MVA) and occasionally by penetrating thoraco abdominal trauma .Blunt traumatic diaphragmatic rupture (BTDR) is a life threatening condition with an incidence of 0.8%–1.6% in blunt trauma [1–3]. The diagnosis often happens to be late due to the absence of typical symptoms or other major injuries dominating the clinical aspect [4]. An isolated BTDR is rare. Here we present a rare case of isolated blunt traumatic diaphragmatic rupture with its review of literature.text/html2013-07-09T05:31:10+01:00http://www.webmedcentral.com/Dr. Gianrocco MancoIndications and Surgical Techniques In the Treatment of Complicated Acute Diverticulitis. Retrospective Study of a 13 Year Old case History
http://www.webmedcentral.com/article_view/4324
Introduction: For "acute complicated diverticulitis" means the presence of complications related to the evolution of the acute inflammatory process.
Objectives of the Study: To identify which surgical technique will achieve the best results; verify the feasibility and applicability of non-resective surgical techniques.
Materials and Methods: This retrospective observational study was developed from
January 1st. 2000 to April 30 th. 2013. The Observation Period has been divided into two: First Period (1st Jan 2000 – 31st Dec 2009) and Second Period (1st Jan 2010 – 30th Apr 2013). For each of the two periods, the sample was divided into two groups: Group A (Patients undergoing a NOT resection treatment,NRT) and Group B (Patients who underwent surgical RESECTION, RT). The Surgical Outcomes used for statistical comparisons between the different groups were: post-operative morbidity, surgical site infections, Re-interventions, Mortality and average Hospitalization.
Results: 78 patients were enrolled in the study, 55 patients in the First Period and 23 patients in the Secondo Period. In the First Period, diverticular peritonitis was characterized by a high rate of mortality, 9 patients died. In the Second Period the 87.5% of patients in Group A presented a score of Hinchey III compard with 20% of patients in group B.
Conclusion: Certainly, further prospective, randomized studies on a larger scale, will need to check what are the short-and long-term results by one surgical technique over any other. Meanwhile the experience and skill of the surgeon associated with post-operative intensive care remain the key variables that improve the prognosis of these patientstext/html2013-07-26T04:16:25+01:00http://www.webmedcentral.com/Dr. Gianrocco MancoPost-operative complications after abdominal surgery in patients treated with oral anticoagulant therapy
http://www.webmedcentral.com/article_view/4353
Introduction: The management of oral anticoagulant therapy preceding abdominal surgery is a clinical problem that will be more and more frequent in the coming years.
Objectives: To investigate the correlation between comorbidities (at the time of surgical treatment) and abdominal surgery post-operative complications in patients treated with OAT, in order to identify risk stratification, correct timing of surgical treatment and postoperative support requirement.
Materials and Methods: In this Prospective Observational Study all patients undergoing abdominal programmed surgery between September 1st 2009 and May 31th 2011 were enrolled. Surgical outcomes and complications were recorded (transfusion requirements, anastomotic leaks, abdominal wall collections, abdominal collections, re-interventions, infections, anemia, hospital re-admission, death).
Results: A total of 834 patients were therefore considered,35 inOAT (Group A) and 780 not in OAT (Group B). Seven patients in Group A and 153 patients in Group B required transfusion (20,0% vs 19,6%, p= ns), with a mean of 2.71 RBC units required in Group A and2.75 inGroup B. As for fresh frozen plasma, the mean requirement was 0.57 units in Group A as compared to 0.24 units in Group B (p= ns).
Conclusions: Although bleeding in the peri-operative period was feared, hemorrhagic events were not more frequent in the OAT group as compared to the non-OAT one. On the contrary, the most serious complications, including death, were related to thrombotic episodes. A multidisciplinary evaluation is therefore fundamental for these patients, requiring the implementation of new "ad hoc" guidelines.text/html2010-10-19T22:05:39+01:00http://www.webmedcentral.com/Dr. Nikhil V GulavaniCaecal Bascule- A Case Report And Review Of Literature
http://www.webmedcentral.com/article_view/1022
Caecal volvulus is a malrotational abnormality of the intestine that causes obstruction. Diagnosis is difficult and, if delayed, the results may be intestinal ischemia, perforation, sepsis, and even death.In the absence of ischemia, decompressive tube cecostomy, simple detorsion, and cecopexy have all been recommended, but the optimal treatment is a matter of controversy.This young male was admitted for left renal calculus, and underwent Percutaneous Nephrolothotomy (PCNL), 5 days following which he presented with featurs of acute intestinal obstruction. He was diagnosed to have caecal volvulus with malrotation of gut. He had history of surgery ( Anoplasty ) done for anorectal malformation at birth.Review of literature says- Caecal volvulus is occasionally precipitated after abdominal procedures which require variation in postion, which causes medial visceral rotation. Also volvulus is more commonly associated with congenital abnormalities like malrotation of gut, anorectal malformation etc. which our patient had.
text/html2010-12-10T19:36:02+01:00http://www.webmedcentral.com/Dr. Karthikeyan SelvarajuA Left Paraduodenal Hernia Causing Recurrent Small Bowel Obstruction : A Case Report
http://www.webmedcentral.com/article_view/1308
Among the congenital internal hernias, paraduodenal hernias are the most common and account for 25%-53% of all cases [1]. Paraduodenal hernias result from abnormal rotation of the midgut during embryonic development and can be divided into two subtypes, left and right paraduodenal hernias, according to their distinct pathogenesis and the resultant anatomical derangement. Internal hernias are important but under diagnosed entities.Clinical symptoms may be intermittent and nonspecific and usually include some degree of nausea, distension and abdominal pain; however, with the advent of modern imaging technology, more information can be gained regarding the anatomical characteristics of the underlying lesion and allow for better treatment planning. We present a rare case of left paraduodenal hernia presenting as recurrent intestinal obstruction, as well as a brief review of the literature.