Pub Date : 2024-07-19DOI: 10.18203/2349-2902.isj20241975
Gerardo M. Mendez, Miguel A. S. Juárez, Alejandro C. Jimenez, Axel T. O. Santamaría, Iván T. Torres
Congenital hepatic hemangioma (CHH) is a benign vascular malformation of the liver observed in newborns. Despite its rarity, it is crucial to understand its clinical presentation, diagnosis, and management due to potential complications. This extensive bibliographic review compiles key references to provide a detailed overview of the epidemiology, pathogenesis, clinical manifestations, diagnostic methods, and therapeutic options for CHH, aiming to offer a comprehensive insight into this condition.
{"title":"Congenital hepatic hemangioma: a review","authors":"Gerardo M. Mendez, Miguel A. S. Juárez, Alejandro C. Jimenez, Axel T. O. Santamaría, Iván T. Torres","doi":"10.18203/2349-2902.isj20241975","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241975","url":null,"abstract":"Congenital hepatic hemangioma (CHH) is a benign vascular malformation of the liver observed in newborns. Despite its rarity, it is crucial to understand its clinical presentation, diagnosis, and management due to potential complications. This extensive bibliographic review compiles key references to provide a detailed overview of the epidemiology, pathogenesis, clinical manifestations, diagnostic methods, and therapeutic options for CHH, aiming to offer a comprehensive insight into this condition.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"120 39","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141821953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-19DOI: 10.18203/2349-2902.isj20241974
Fernando G. R. Estrada, Miguel A. S. Juarez, Marlon E. L. Valenzuela
Pelvic congestion syndrome (PCS) is a pathology characterized by pain in the pelvic region that occurs chronically and is usually associated with the presence of varicose veins in the genital, vulvar or perineal region as a consequence of venous reflux of gonadal, gluteal or peri uterine veins, as well as compression syndromes in the left renal veins or iliac segments, which can lead to a spectrum of clinical symptoms ranging from dysuria, pain when standing, dyspareunia and intense dysmenorrhea, or equally psychological symptoms such as mood disorders or depression, which affect the quality of life of patients. Despite its high prevalence, this disease continues to be underdiagnosed and mistreated. The etiology varies involving factors in mechanics, hemodynamics, anatomical defects, anomalies of venous return, multiparity, including hormonal factors, obesity, or sedentary lifestyle, which favor blood stasis and consequent venous dilation. The diagnosis is made with an appropriate clinical examination, and confirmed with imaging studies, phlebography being the gold standard due to its diagnostic and therapeutic usefulness. There is currently a wide variety in the treatment of PCS, however endovascular management with sclerotherapy and embolization is the one that has shown the best results with clinical improvement and quality of life. This article seeks to review the literature on pelvic congestion syndrome with the aim of understanding a frequently overlooked disease and the diagnostic and therapeutic alternatives to treat these patients.
{"title":"Pelvic congestion syndrome and its treatment: topic review","authors":"Fernando G. R. Estrada, Miguel A. S. Juarez, Marlon E. L. Valenzuela","doi":"10.18203/2349-2902.isj20241974","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241974","url":null,"abstract":"Pelvic congestion syndrome (PCS) is a pathology characterized by pain in the pelvic region that occurs chronically and is usually associated with the presence of varicose veins in the genital, vulvar or perineal region as a consequence of venous reflux of gonadal, gluteal or peri uterine veins, as well as compression syndromes in the left renal veins or iliac segments, which can lead to a spectrum of clinical symptoms ranging from dysuria, pain when standing, dyspareunia and intense dysmenorrhea, or equally psychological symptoms such as mood disorders or depression, which affect the quality of life of patients. Despite its high prevalence, this disease continues to be underdiagnosed and mistreated. The etiology varies involving factors in mechanics, hemodynamics, anatomical defects, anomalies of venous return, multiparity, including hormonal factors, obesity, or sedentary lifestyle, which favor blood stasis and consequent venous dilation. The diagnosis is made with an appropriate clinical examination, and confirmed with imaging studies, phlebography being the gold standard due to its diagnostic and therapeutic usefulness. There is currently a wide variety in the treatment of PCS, however endovascular management with sclerotherapy and embolization is the one that has shown the best results with clinical improvement and quality of life. This article seeks to review the literature on pelvic congestion syndrome with the aim of understanding a frequently overlooked disease and the diagnostic and therapeutic alternatives to treat these patients.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"121 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09DOI: 10.18203/2349-2902.isj20241956
Ryan J. Green, Sarath Vennam, Corey Kirkham, Conor Aylward, William Caufield, Lucy Andraloj, Miles Geldart, James Sellars
This case report highlights the diagnostic challenges posed by retroperitoneal soft tissue sarcoma (STS) presenting as an iliopsoas abscess, mimicking common symptoms and radiological findings. This patients’ symptoms recurred despite multiple percutaneous drains and revisions over a period of months. Further investigation revealed a partly solid, partly cystic mass consistent with sarcoma. Surgical excision confirmed the diagnosis, but recurrence necessitated palliation. This case emphasizes the importance of differential diagnoses of iliopsoas collection and the need for research into alternative imaging modalities to aid clinicians and radiologists in differentiating benign retroperitoneal collections from malignancy.
{"title":"Retroperitoneal soft tissue sarcoma, a rare mimic and important differential of iliopsoas abscess","authors":"Ryan J. Green, Sarath Vennam, Corey Kirkham, Conor Aylward, William Caufield, Lucy Andraloj, Miles Geldart, James Sellars","doi":"10.18203/2349-2902.isj20241956","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241956","url":null,"abstract":"This case report highlights the diagnostic challenges posed by retroperitoneal soft tissue sarcoma (STS) presenting as an iliopsoas abscess, mimicking common symptoms and radiological findings. This patients’ symptoms recurred despite multiple percutaneous drains and revisions over a period of months. Further investigation revealed a partly solid, partly cystic mass consistent with sarcoma. Surgical excision confirmed the diagnosis, but recurrence necessitated palliation. This case emphasizes the importance of differential diagnoses of iliopsoas collection and the need for research into alternative imaging modalities to aid clinicians and radiologists in differentiating benign retroperitoneal collections from malignancy.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"28 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141665036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09DOI: 10.18203/2349-2902.isj20241955
José Fernando Montiel Catañeda, Raúl Manuel Cota García, Antonio Valencia Vega, Darinel Osorio Gómez, Roman Esteban Hernández González, Brayant López García, Gabriela Díaz Salas, Miguel Ángel Adame Anzo, María José Cabrera Chávez, Jahat Uziel Lindoro Salgueiro
To review the etiology, clinical presentation, diagnostic evaluation, management, and prognosis of giant pancreatic cysts. Giant pancreatic cysts, defined as cysts exceeding 5 cm in diameter, include a diverse group of lesions such as pseudocysts, serous cystadenomas, mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Their clinical significance stems from potential complications and the necessity to differentiate benign from malignant cysts. A comprehensive review of the literature was conducted, focusing on the pathophysiology, symptomatology, diagnostic modalities, treatment options, and outcomes associated with giant pancreatic cysts. The etiology of giant pancreatic cysts varies from benign conditions like pseudocysts and serous cystadenomas to potentially malignant or malignant neoplasms such as MCNs and IPMNs. Clinical presentation ranges from asymptomatic cases to severe abdominal symptoms and complications. Diagnostic evaluation includes imaging modalities like ultrasound, CT, MRI/MRCP, and endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) for cytology and biochemical analysis. Management strategies depend on the type and characteristics of the cyst, with options including observation, endoscopic drainage, surgical resection, and percutaneous drainage. The prognosis varies, with benign cysts generally having a favorable outcome, while cysts with malignant potential require timely surgical intervention to improve survival rates. Giant pancreatic cysts pose a diagnostic and therapeutic challenge due to their varied etiologies and potential complications. Accurate diagnosis through advanced imaging and fluid analysis is crucial. Management should be tailored based on the cyst type, symptoms, and malignancy risk, involving a multidisciplinary approach to optimize patient outcomes. Further advancements in diagnostic and therapeutic techniques are anticipated to enhance the management of these complex lesions.
{"title":"Giant pancreatic cyst with extension to spleen managed by laparoscopy","authors":"José Fernando Montiel Catañeda, Raúl Manuel Cota García, Antonio Valencia Vega, Darinel Osorio Gómez, Roman Esteban Hernández González, Brayant López García, Gabriela Díaz Salas, Miguel Ángel Adame Anzo, María José Cabrera Chávez, Jahat Uziel Lindoro Salgueiro","doi":"10.18203/2349-2902.isj20241955","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241955","url":null,"abstract":"To review the etiology, clinical presentation, diagnostic evaluation, management, and prognosis of giant pancreatic cysts. Giant pancreatic cysts, defined as cysts exceeding 5 cm in diameter, include a diverse group of lesions such as pseudocysts, serous cystadenomas, mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Their clinical significance stems from potential complications and the necessity to differentiate benign from malignant cysts. A comprehensive review of the literature was conducted, focusing on the pathophysiology, symptomatology, diagnostic modalities, treatment options, and outcomes associated with giant pancreatic cysts. The etiology of giant pancreatic cysts varies from benign conditions like pseudocysts and serous cystadenomas to potentially malignant or malignant neoplasms such as MCNs and IPMNs. Clinical presentation ranges from asymptomatic cases to severe abdominal symptoms and complications. Diagnostic evaluation includes imaging modalities like ultrasound, CT, MRI/MRCP, and endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) for cytology and biochemical analysis. Management strategies depend on the type and characteristics of the cyst, with options including observation, endoscopic drainage, surgical resection, and percutaneous drainage. The prognosis varies, with benign cysts generally having a favorable outcome, while cysts with malignant potential require timely surgical intervention to improve survival rates. Giant pancreatic cysts pose a diagnostic and therapeutic challenge due to their varied etiologies and potential complications. Accurate diagnosis through advanced imaging and fluid analysis is crucial. Management should be tailored based on the cyst type, symptoms, and malignancy risk, involving a multidisciplinary approach to optimize patient outcomes. Further advancements in diagnostic and therapeutic techniques are anticipated to enhance the management of these complex lesions.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"66 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12DOI: 10.18203/2349-2902.isj20241614
R. Ghritlaharey
Extrusion of the distal end of the cerebrospinal fluid (CSF) shunt catheter through the mouth is a rare complication of shunt surgery performed to treat hydrocephalus. A two-year-old girl had her first CSF shunt inserted when she was six months old to treat congenital hydrocephalus. The shunt became infected 2-months later and had to be removed. A few weeks later, a new CSF shunt was inserted on the left side. One year later, she presented with an extrusion of the distal end of the CSF shunt catheter through her mouth. However, she showed no symptoms or signs of peritonitis or meningitis. Her entire CSF shunt system on the left side required removal. A cranial magnetic resonance imaging (MRI) scan showed ventriculomegaly and a new CSF shunt catheter was implanted on the right side. She had an uneventful postoperative period and was doing well during the follow-up. Extrusion of the distal end of the CSF shunt catheter through the mouth is rare and more likely to occur in children, and clinicians need to be aware of such complications.
{"title":"Cerebrospinal fluid shunt catheter extrusion through the mouth in a child: a case report with brief literature review","authors":"R. Ghritlaharey","doi":"10.18203/2349-2902.isj20241614","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241614","url":null,"abstract":"Extrusion of the distal end of the cerebrospinal fluid (CSF) shunt catheter through the mouth is a rare complication of shunt surgery performed to treat hydrocephalus. A two-year-old girl had her first CSF shunt inserted when she was six months old to treat congenital hydrocephalus. The shunt became infected 2-months later and had to be removed. A few weeks later, a new CSF shunt was inserted on the left side. One year later, she presented with an extrusion of the distal end of the CSF shunt catheter through her mouth. However, she showed no symptoms or signs of peritonitis or meningitis. Her entire CSF shunt system on the left side required removal. A cranial magnetic resonance imaging (MRI) scan showed ventriculomegaly and a new CSF shunt catheter was implanted on the right side. She had an uneventful postoperative period and was doing well during the follow-up. Extrusion of the distal end of the CSF shunt catheter through the mouth is rare and more likely to occur in children, and clinicians need to be aware of such complications.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"130 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141351352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12DOI: 10.18203/2349-2902.isj20241613
Rahul G. Reji, C. Vijayakumar, G. Sreenath
Background: Surgical site infections (SSIs) are responsible for increased morbidity and mortality among post-operative patients worldwide. They also increase healthcare costs and prolong the duration of hospital stay. This study aims to determine the incidence of SSIs in elective and emergency general surgery and its association with various risk factors. Methods: A retrospective cohort study was carried out using the case sheets of 200 patients who underwent general surgery in a tertiary public hospital of South India. The patients were selected from two cohorts- emergency and elective (100 from each). The data retrieved from the hospital’s electronic medical records were analyzed using STATA version 14.0. Results: Of the 200 patients included in the study, 57% were men and the mean (range) age was 49.3 (18-88) years; 122 patients (61%) had contaminated wounds, 68 patients (34%) had a pre-existing comorbidity and the average duration of hospital stay was 6.98 days. The overall surgical site infection rate was 11%; 13% in emergency surgery and 9% in elective surgery. Staphylococcus aureus was isolated from 36% of the patients with surgical site infections. Conclusions: Emergency surgery reported a higher infection rate than elective surgery. Old age, pre-existing medical illnesses, wound contamination and prolonged hospital stay were also found to increase the risks for developing SSIs.
{"title":"Surgical site infections in elective and emergency general surgery cases in a tertiary public hospital of South India: a retrospective study","authors":"Rahul G. Reji, C. Vijayakumar, G. Sreenath","doi":"10.18203/2349-2902.isj20241613","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241613","url":null,"abstract":"Background: Surgical site infections (SSIs) are responsible for increased morbidity and mortality among post-operative patients worldwide. They also increase healthcare costs and prolong the duration of hospital stay. This study aims to determine the incidence of SSIs in elective and emergency general surgery and its association with various risk factors.\u0000Methods: A retrospective cohort study was carried out using the case sheets of 200 patients who underwent general surgery in a tertiary public hospital of South India. The patients were selected from two cohorts- emergency and elective (100 from each). The data retrieved from the hospital’s electronic medical records were analyzed using STATA version 14.0.\u0000Results: Of the 200 patients included in the study, 57% were men and the mean (range) age was 49.3 (18-88) years; 122 patients (61%) had contaminated wounds, 68 patients (34%) had a pre-existing comorbidity and the average duration of hospital stay was 6.98 days. The overall surgical site infection rate was 11%; 13% in emergency surgery and 9% in elective surgery. Staphylococcus aureus was isolated from 36% of the patients with surgical site infections.\u0000Conclusions: Emergency surgery reported a higher infection rate than elective surgery. Old age, pre-existing medical illnesses, wound contamination and prolonged hospital stay were also found to increase the risks for developing SSIs.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"44 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.18203/2349-2902.isj20241605
Mohamed Elsheikh, Amir Abdelhamid, Hossam R. Moussa
Background: Pancreaticoduodenectomy is the best curative option for malignant pancreatic head neoplasms with a high perioperative morbidity rate. Pancreatic leak is the most feared complication. This study was done to describe our early and late experience outcomes of PD after implementing technical modifications to decrease the postoperative incidence of pancreatic leak. Methods: The data of 53 patients were collected and divided into two groups: the early experience group (27 cases) and the late experience group (26 cases). The main two modifications performed in late group were Heidelberg technique for pancreatojejunostomy anastomosis (all cases) and irrigation of the pancreatic anastomosis (selected cases). Results: All preoperative demographic, clinical, laboratory, and intraoperative findings showed insignificant differences between the two groups (p≥0.05). Nonetheless, cases in the late group had shorter operative time, less intraoperative blood loss, and less need for blood transfusion (p<0.05(. Postoperatively, the incidence of pancreatic leak decreased with technical modifications (11.54% vs. 37.04% in the early group). The late group showed earlier time to oral intake and shorter hospitalization periods. In-hospital mortality occurred in 14.81% of early cases secondary to pancreatic leak and subsequent secondary haemorrhage and multiorgan failure. Obesity (p<0.001), soft pancreas (p<0.001), and small pancreatic duct diameter (p=0.007) were significant predictors of pancreatic leak. Conclusions: Surgical expertise and technical modifications play a crucial role in improving PD outcomes with less incidence of complications, earlier oral intake, and shorter hospitalization period.
{"title":"Reduction of pancreatic leak rate after pancreaticoduodenectomy by changing anastomotic and drainage techniques: a long-term single center experience","authors":"Mohamed Elsheikh, Amir Abdelhamid, Hossam R. Moussa","doi":"10.18203/2349-2902.isj20241605","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241605","url":null,"abstract":"Background: Pancreaticoduodenectomy is the best curative option for malignant pancreatic head neoplasms with a high perioperative morbidity rate. Pancreatic leak is the most feared complication. This study was done to describe our early and late experience outcomes of PD after implementing technical modifications to decrease the postoperative incidence of pancreatic leak.\u0000Methods: The data of 53 patients were collected and divided into two groups: the early experience group (27 cases) and the late experience group (26 cases). The main two modifications performed in late group were Heidelberg technique for pancreatojejunostomy anastomosis (all cases) and irrigation of the pancreatic anastomosis (selected cases).\u0000Results: All preoperative demographic, clinical, laboratory, and intraoperative findings showed insignificant differences between the two groups (p≥0.05). Nonetheless, cases in the late group had shorter operative time, less intraoperative blood loss, and less need for blood transfusion (p<0.05(. Postoperatively, the incidence of pancreatic leak decreased with technical modifications (11.54% vs. 37.04% in the early group). The late group showed earlier time to oral intake and shorter hospitalization periods. In-hospital mortality occurred in 14.81% of early cases secondary to pancreatic leak and subsequent secondary haemorrhage and multiorgan failure. Obesity (p<0.001), soft pancreas (p<0.001), and small pancreatic duct diameter (p=0.007) were significant predictors of pancreatic leak.\u0000Conclusions: Surgical expertise and technical modifications play a crucial role in improving PD outcomes with less incidence of complications, earlier oral intake, and shorter hospitalization period.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"81 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-18DOI: 10.18203/2349-2902.isj20241308
Prashanth C., Neetha V., Likhith Kumar R., Manohar T. M.
Background: The aim of this study is to compare the results of ultrasound guided aspiration and incision and drainage in the management of breast abscess. Methods: This is a comparative study of between ultrasound guided aspiration and incision and drainage, consist of 50 patients with breast abscess who underwent both the treatment alternatively in our institution Sri. Siddhartha Institute of Medical Sciences and Research Begur during 2021 to 2023. 7th and 14th day following aspiration, patients should be assessed both clinically and by USG breast. Results were tabulated and analyzed. Results: 4 patients developed complications following Incision and drainage. 3 milk fistula and wound gaping, 1 recurrence and 3 patients developed complications following USG guided aspiration All 3 cases were recurrence. Conclusions: USG guided aspiration is simple, painless, day care procedure and effective alternative method of treatment to incision and drainage in properly selected patient and with timely support by sonologist with early postoperative recovery and good patient satisfaction.
背景：本研究旨在比较超声引导下抽吸和切开引流术治疗乳腺脓肿的效果：本研究旨在比较超声引导下抽吸术和切开引流术治疗乳腺脓肿的效果：这是一项关于超声引导下抽吸术与切开引流术的比较研究，研究对象是在 2021 年期间在本院 Sri.Siddhartha Institute of Medical Sciences and Research Begur的50名乳腺脓肿患者。抽吸后第 7 天和第 14 天，患者应接受临床和乳腺 USG 评估。对结果进行列表和分析：结果：4 名患者在切开引流术后出现并发症。结果：4 例患者在切开引流术后出现并发症，3 例出现乳瘘和伤口裂开，1 例复发，3 例患者在 USG 引导下抽吸术后出现并发症，所有 3 例均为复发：结论：USG 引导下抽吸术是一种简单、无痛、日间护理的手术，对于经过适当选择的患者，在超声科医生的及时支持下，可有效替代切开引流术，术后恢复快，患者满意度高。
{"title":"Ultrasound guided aspiration versus incision and drainage in the management of breast abscess","authors":"Prashanth C., Neetha V., Likhith Kumar R., Manohar T. M.","doi":"10.18203/2349-2902.isj20241308","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241308","url":null,"abstract":"Background: The aim of this study is to compare the results of ultrasound guided aspiration and incision and drainage in the management of breast abscess.\u0000Methods: This is a comparative study of between ultrasound guided aspiration and incision and drainage, consist of 50 patients with breast abscess who underwent both the treatment alternatively in our institution Sri. Siddhartha Institute of Medical Sciences and Research Begur during 2021 to 2023. 7th and 14th day following aspiration, patients should be assessed both clinically and by USG breast. Results were tabulated and analyzed.\u0000Results: 4 patients developed complications following Incision and drainage. 3 milk fistula and wound gaping, 1 recurrence and 3 patients developed complications following USG guided aspiration All 3 cases were recurrence.\u0000Conclusions: USG guided aspiration is simple, painless, day care procedure and effective alternative method of treatment to incision and drainage in properly selected patient and with timely support by sonologist with early postoperative recovery and good patient satisfaction.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"105 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.18203/2349-2902.isj20241306
Wiwin Suhandri, Diki Riandi
Heterotopic pregnancy (HP) represents a rare and complex condition where simultaneous pregnancies occur at different implantation sites, with only one located within the uterine cavity. Typically diagnosed in the first trimester, HP presents diagnostic challenges due to its rarity and varying clinical presentations. Here, we present a unique case of HP diagnosed at Bengkalis Hospital involving a 42-year-old multipara at 12 weeks of gestation. The patient's presentation included regular uterine contractions and upper abdominal pain, with a positive Plano test upon admission. Despite experiencing vaginal bleeding two days prior and an initial refusal of care, further examination revealed a 2.13 cm gestational sac in the intrauterine cavity, consistent with the gestational age. Additionally, free intra-abdominal fluid was observed in the Douglas cavity. Haematological examination indicated a low haemoglobin level of 7.2 g/dl and elevated leukocytes at 16,000. An emergency laparotomy revealed a ruptured right ovarian tube containing a gestational sac, which was managed with hemostasis and a subsequent salpingectomy. The left ovarian tube underwent a tubectomy as a preventive measure. The patient received multiple blood transfusions, leading to an improvement in haemoglobin levels to 10.2 g/dl postoperatively. Following a two-day hospitalisation, the patient was discharged in good general condition. HP cases often necessitate laparotomies for tubal pregnancies, and ultrasound plays a crucial role in diagnosis, especially given its prevalence of 1 in 7000 due to assisted reproduction. Treatment typically involves laparoscopic or laparotomic intervention, highlighting the multidisciplinary approach required for managing this rare condition.
异位妊娠（HP）是一种罕见而复杂的病症，即同时妊娠发生在不同的着床部位，只有一个着床部位位于子宫腔内。异位妊娠通常在妊娠头三个月被诊断出来，由于其罕见性和不同的临床表现，给诊断带来了挑战。在此，我们介绍一例在 Bengkalis 医院确诊的独特 HP 病例，患者 42 岁，多胎，妊娠 12 周。患者表现为规律性子宫收缩和上腹部疼痛，入院时普拉诺试验呈阳性。尽管患者两天前曾出现阴道出血，而且最初拒绝接受治疗，但进一步检查发现宫腔内有一个 2.13 厘米的妊娠囊，与孕龄相符。此外，在道格拉斯腔内还发现了游离的腹腔积液。血液检查显示血红蛋白水平低至 7.2 g/dl，白细胞升高至 16 000。紧急开腹手术显示右侧卵巢管破裂，内含一个妊娠囊，经止血处理后进行了输卵管切除术。作为预防措施，对左侧卵巢管进行了切除。患者接受了多次输血，术后血红蛋白水平提高到 10.2 g/dl。经过两天的住院治疗，患者出院时全身状况良好。输卵管妊娠 HP 病例通常需要开腹手术，超声波在诊断中起着至关重要的作用，特别是考虑到由于辅助生殖，其发病率高达 1/7000。治疗方法通常包括腹腔镜或腹腔镜干预，这突出说明了治疗这种罕见疾病所需的多学科方法。
{"title":"A heterotopic pregnancy at 12 weeks’ pregnancy","authors":"Wiwin Suhandri, Diki Riandi","doi":"10.18203/2349-2902.isj20241306","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241306","url":null,"abstract":"Heterotopic pregnancy (HP) represents a rare and complex condition where simultaneous pregnancies occur at different implantation sites, with only one located within the uterine cavity. Typically diagnosed in the first trimester, HP presents diagnostic challenges due to its rarity and varying clinical presentations. Here, we present a unique case of HP diagnosed at Bengkalis Hospital involving a 42-year-old multipara at 12 weeks of gestation. The patient's presentation included regular uterine contractions and upper abdominal pain, with a positive Plano test upon admission. Despite experiencing vaginal bleeding two days prior and an initial refusal of care, further examination revealed a 2.13 cm gestational sac in the intrauterine cavity, consistent with the gestational age. Additionally, free intra-abdominal fluid was observed in the Douglas cavity. Haematological examination indicated a low haemoglobin level of 7.2 g/dl and elevated leukocytes at 16,000. An emergency laparotomy revealed a ruptured right ovarian tube containing a gestational sac, which was managed with hemostasis and a subsequent salpingectomy. The left ovarian tube underwent a tubectomy as a preventive measure. The patient received multiple blood transfusions, leading to an improvement in haemoglobin levels to 10.2 g/dl postoperatively. Following a two-day hospitalisation, the patient was discharged in good general condition. HP cases often necessitate laparotomies for tubal pregnancies, and ultrasound plays a crucial role in diagnosis, especially given its prevalence of 1 in 7000 due to assisted reproduction. Treatment typically involves laparoscopic or laparotomic intervention, highlighting the multidisciplinary approach required for managing this rare condition.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"49 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.18203/2349-2902.isj20241307
Owaid M. Almalki
Background: Laparoscopic sleeve gastrectomy (LSG) is a prevalent bariatric procedure known for its efficacy in weight loss and amelioration of obesity-related comorbidities. However, postoperative bleeding from the staple line remains a significant complication, necessitating strategies for effective hemostasis. Tranexamic acid (TXA) has shown promise in reducing bleeding complications in various surgical contexts, yet its role in LSG remains underexplored due to concerns about thromboembolic risks. Methods: This retrospective comparative analysis examines the impact of prophylactic TXA administration on perioperative bleeding in LSG patients. Two cohorts of 100 patients each, undergoing LSG before and after TXA implementation, were analyzed. Demographic, clinical, and outcome data were collected and statistically analyzed. Results: In our study, 100 patients received TXA with a mean age of 36.8±12.18 years, while another 100 formed the non-TXA group with a mean age of 37.2±11.81 years. Pre-surgery, clinical characteristics and hemodynamic parameters did not significantly differ between groups. However, post-surgery, TXA patients showed significantly elevated hemoglobin levels (p=0.019), increased hematocrit (p<0.001), higher prothrombin activity (p=0.002), decreased INR values (p=0.012), and higher fibrinogen levels (p=0.014) compared to non-TXA patients. Three non-TXA patients experienced post-operative bleeding requiring ICU admission and transfusions. The mean length of stay was 2.1±0.5 days for TXA patients and 2.2±0.03 days for non-TXA patients. No venous thromboembolism (VTE) or deaths occurred in either group. Conclusions: The integration of prophylactic TXA into perioperative protocols for LSG holds promise in optimizing hemostasis and enhancing patient outcomes. TXA serves as a valuable adjunctive strategy towards minimizing bleeding events and bolstering safety in LSG procedures.
{"title":"Towards zero bleeding after laparoscopic sleeve gastrectomy: investigating the impact of prophylactic tranexamic acid","authors":"Owaid M. Almalki","doi":"10.18203/2349-2902.isj20241307","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20241307","url":null,"abstract":"Background: Laparoscopic sleeve gastrectomy (LSG) is a prevalent bariatric procedure known for its efficacy in weight loss and amelioration of obesity-related comorbidities. However, postoperative bleeding from the staple line remains a significant complication, necessitating strategies for effective hemostasis. Tranexamic acid (TXA) has shown promise in reducing bleeding complications in various surgical contexts, yet its role in LSG remains underexplored due to concerns about thromboembolic risks.\u0000Methods: This retrospective comparative analysis examines the impact of prophylactic TXA administration on perioperative bleeding in LSG patients. Two cohorts of 100 patients each, undergoing LSG before and after TXA implementation, were analyzed. Demographic, clinical, and outcome data were collected and statistically analyzed.\u0000Results: In our study, 100 patients received TXA with a mean age of 36.8±12.18 years, while another 100 formed the non-TXA group with a mean age of 37.2±11.81 years. Pre-surgery, clinical characteristics and hemodynamic parameters did not significantly differ between groups. However, post-surgery, TXA patients showed significantly elevated hemoglobin levels (p=0.019), increased hematocrit (p<0.001), higher prothrombin activity (p=0.002), decreased INR values (p=0.012), and higher fibrinogen levels (p=0.014) compared to non-TXA patients. Three non-TXA patients experienced post-operative bleeding requiring ICU admission and transfusions. The mean length of stay was 2.1±0.5 days for TXA patients and 2.2±0.03 days for non-TXA patients. No venous thromboembolism (VTE) or deaths occurred in either group.\u0000Conclusions: The integration of prophylactic TXA into perioperative protocols for LSG holds promise in optimizing hemostasis and enhancing patient outcomes. TXA serves as a valuable adjunctive strategy towards minimizing bleeding events and bolstering safety in LSG procedures.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"48 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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