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Peritonitis due to peptic ulcer perforation: Epidemiological, diagnostic and therapeutic aspects in the general surgery department of the Idrissa POUYE general hospital 消化性溃疡穿孔所致腹膜炎:Idrissa POUYE综合医院普外科的流行病学、诊断和治疗方面
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i1b.983
I. Ka, A. Faye, A. Diop, P. S. Diop
Introduction: Peritonitis is an acute inflammation of the peritoneal serosa due to the presence in the peritoneal cavity of an aggressive liquid, but not necessarily septic, which may be generalized or localized, primary or secondary often to a perforation of peptic ulcer. The objective of our work is to study the epidemiological, diagnostic and therapeutic aspects of acute generalized peritonitis due to peptic ulcer perforation in the General Surgery Department of the Idrissa POUYE General Hospital. Patients and Method: This was a retrospective and descriptive monocentric study of 72 cases of acute generalized peritonitis due to peptic ulcer perforation from January 1st 2008 to December 31st 2021. Results: The prevalence of peritonitis due to peptic ulcer perforation was 4.3% in surgical emergencies at the Idrissa POUYE general hospital in Dakar. The average age of our patients was 36.3 years with extremes of 16 and 67 years. The clinical signs were mainly abdominal pain (100%), vomiting 75% (N=54), transit arrest 69.44% (N=50). An X-ray of the abdomen without preparation was performed in 79.17% of cases (N=57) with the presence of pneumoperitoneum in 89.4% of cases (N=51). Surgical treatment was performed in 95.83% of patients (N=69). Postoperative complications were observed in 9 patients (13.04%) and operative mortality was 2 patients (2.89%). Conclusion: Peritonitis due to ulcer perforation is a medical-surgical emergency that mainly affects young subjects. The diagnosis is above all clinical, confirmed by the radiography of the abdomen without preparation.
导读:腹膜炎是腹膜浆膜的一种急性炎症,由于腹膜腔中存在侵袭性液体,但不一定是化脓性的,它可以是全身性的或局部的,原发性或继发性的,通常是消化性溃疡穿孔。我们的工作目的是研究伊德里萨普耶综合医院普外科消化性溃疡穿孔引起的急性广泛性腹膜炎的流行病学、诊断和治疗方面的问题。患者和方法:这是一项回顾性和描述性的单中心研究,对2008年1月1日至2021年12月31日72例因消化性溃疡穿孔引起的急性广泛性腹膜炎进行了研究。结果:达喀尔Idrissa POUYE综合医院外科急诊中消化性溃疡穿孔引起的腹膜炎患病率为4.3%。患者平均年龄为36.3岁,极端年龄为16岁和67岁。临床症状以腹痛为主(100%),呕吐为主(54例),中转骤停69.44%(50例)。79.17%的病例(N=57)未做腹部x线检查,89.4%的病例(N=51)存在气腹。95.83%的患者接受手术治疗(N=69)。术后并发症9例(13.04%),手术死亡率2例(2.89%)。结论:溃疡穿孔所致腹膜炎是一种以年轻人为主的内科外科急症。诊断首先是临床,由腹部x线片证实,没有准备。
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引用次数: 0
Laser procedure for grade 2 and grade 3 haemorrhoids Authors 2级和3级痔疮的激光治疗
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3a.1008
Dr. Saurabh Raut, Dr. Sanjiv Thakur, Dr. Ritvik Jaykar, Dr. Ameya Sanjiv Thakur
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引用次数: 0
Study of clinical profile of acute limb cellulitis patients in tertiary care center 三级保健中心急性肢体蜂窝织炎的临床分析
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3b.1012
Dr. Ritvik Jaykar, Dr. Sachin Jadhav, Dr. Omkar Shende, Dr. Shantanu Kalpallivar
Background: This high volume, single centre study investigated the clinical profile of acute limb cellulitis patients in terms of prevalence, etiological factors, bacterial epidemiology, responsiveness to antibiotic therapy and outcome of different treatment modalities. Materials and Methods: This is a prospective observational study in our tertiary care hospital. Total 100 cases of limb cellulitis were evaluated from 2020 to 2023. Data about the selected cases collected to provide demographics, cellulitis grading, symptoms, complications, cultures
背景:这项大容量、单中心研究调查了急性肢体蜂窝织炎患者的临床概况,包括患病率、病因、细菌流行病学、对抗生素治疗的反应性和不同治疗方式的结果。材料与方法:本研究是在我院三级医院进行的前瞻性观察性研究。对2020 - 2023年共100例肢体蜂窝织炎进行评估。收集有关选定病例的数据,以提供人口统计学,蜂窝织炎分级,症状,并发症,培养
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引用次数: 0
Oral primitive neuroectodermal tumor associated with mandibular lymphadenopathy in three-year-old female Indonesian children: A rare case report 三岁印尼女性儿童口腔原始神经外胚层肿瘤合并下颌骨淋巴结病:一罕见病例报告
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i4a.1025
Chandra Analis Permatasari, Dewi Haryanti Kurniasih
Introduction: Primitive neuroectodermal tumors (PNETs) are rare and aggressive malignancies derived from primitive neural crest cells in the CNS, with peripheral variants known as peripheral PNETs (pPNETs) found in soft tissues. Diagnosing PNETs is challenging due to their rarity and resemblance to other neoplastic conditions like Ewing's sarcoma and rhabdomyosarcoma. Case Presentation: A 3-year-old female child presented with a growing bump on her lips, causing obstruction of the mouth and both of the nostrils hence impairing daily living. Examination revealed an irregular mass with signs of tissue necrosis and bleeding. A blood test and head CT scan indicated a benign mass, potentially a hemangioma, with submandibular lymphadenopathy and leukocytosis. The patient underwent a debridement procedure and a subsequent operation to excise part of the mass for histopathological analysis. The results revealed a primitive neuroectodermal tumor, specifically a melanotic neuroectodermal tumor of infancy (MNTI). Discussion: Peripheral PNETs are more commonly seen in older individuals with abdominal/pelvic and thoracic-pulmonary lesions being the most frequent. Our case of a 3-year- old Indonesian child with a distinct oral cavity PNET is considered rare among the age and race groups. Conclusion: The case of a three-year-old Indonesian female child with peripheral PNET in the submandibular region is an uncommon presentation in terms of age, tumor location, race, and ethnicity. Clinicians should be aware of such rare possibilities and follow thorough histopathology and immunohistochemistry tests to establish an accurate diagnosis.
原始神经外胚层肿瘤(PNETs)是一种罕见的侵袭性恶性肿瘤,起源于中枢神经系统的原始神经嵴细胞,在软组织中发现的外周变异体称为外周PNETs (pPNETs)。诊断PNETs具有挑战性,因为它们罕见且与其他肿瘤条件(如尤文氏肉瘤和横纹肌肉瘤)相似。病例介绍:一名3岁女童,嘴唇肿块增大,导致嘴巴和双鼻孔阻塞,影响日常生活。检查发现不规则肿块,伴有组织坏死和出血。血液检查和头部CT扫描显示良性肿块,可能是血管瘤,伴下颌下淋巴结病和白细胞增多。患者接受了清创手术和随后的手术切除部分肿块进行组织病理学分析。结果显示为原始神经外胚层肿瘤,特别是婴儿期黑色素神经外胚层肿瘤(MNTI)。讨论:外周PNETs更常见于老年人,腹部/盆腔和胸肺病变最常见。我们的病例是一个3岁的印度尼西亚儿童,有明显的口腔PNET,在年龄和种族群体中被认为是罕见的。结论:一名三岁印度尼西亚女童在下颌下区域出现外周PNET的病例在年龄、肿瘤位置、种族和民族方面都是罕见的。临床医生应该意识到这种罕见的可能性,并遵循彻底的组织病理学和免疫组织化学测试,以建立准确的诊断。
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引用次数: 0
Laparoscopic appendectomy for complicated acute appendicitis in Tikrit emergency hospital 提克里特急诊医院腹腔镜阑尾切除术治疗复杂急性阑尾炎
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i4b.1031
Thaer J Mohammed, Mohammed S Qadoori, Abdulnaser A Salih
Background: With a prevalence of 1.17 cases per 1000 people and an approximate 7 percent risk over the course of a lifetime, acute appendicitis continues to be one of the most common causes of acute abdominal pain Materials and Methods: During the time period of this observational study, which began on January 1, 2022 and ended on November 30, 2022, 57 patients were admitted to the emergency unit of Tikrit General Hospital with a diagnosis of suspected complicated acute appendicitis. Antibiotics and fluids were given intravenously to the patient before the operation. Pneumo-peritoneum was created using either the Verrus needle or the Hasson open approach while the patient was under general anesthesia and intubated with an endotracheal tube. Additionally, the patient was positioned in the supine position. The appendix could be extracted using either the endo-catch bag or the 10 mm port, depending on which method was used. After performing a peritoneal wash with saline until the wash fluid turned clear, an intra-peritoneal tube drain was left either in an appendicular bed or the pelvis. Results: The study enrolled 57 participants (38 females, 19 males) with a mean age of 26.73±6.5 years, ranging from 17 to 50 years. All patients underwent diagnostic laparoscopy, and intra-operative findings showed that 26 patients (45.61%) had perforated appendicitis, 13 patients (22.81%) had gangrenous appendicitis, 11 patients (19.30%) had appendicular abscess, and 7 patients (12.28%) had appendicular mass. The mean operation time was 49.5±16.86 minutes, with a range of 39 to 117 minutes. Laparoscopy was the preferred option for 52 patients (91.23%), while 5 patients required open surgery. Hospital stay duration varied, with 13 patients staying for 2 days, 20 patients for 3 days, 17 patients for 4 days, and 4 patients for more than 5 days. During the post-operative follow-up, 43 patients had no complications (75.44%), 2 patients (3.51%) had a fever with a collection on follow-up ultrasound, 5 patients (8.77%) had a fever without a collection, 2 patients (3.51%) had postoperative ileus, and 3 patients (5.26%) had wound seroma or infected seroma.Conclusions: This study shows that laparoscopic appendectomy may treat severe appendicitis safely and effectively. It reduced hospital stays and conversions. Prevents postoperative infections.
背景:急性阑尾炎的患病率为每1000人1.17例,一生中风险约为7%,仍然是急性腹痛最常见的原因之一。材料和方法:在这项观察性研究期间,从2022年1月1日开始到2022年11月30日结束,57名患者被提克里特总医院急诊室收治,诊断为疑似并发症急性阑尾炎。手术前给病人静脉注射抗生素和液体。在患者全身麻醉和气管内插管的情况下,使用Verrus针或Hasson开放入路制造腹膜充气。此外,将患者置于仰卧位。根据使用的方法不同,阑尾可采用夹尾袋或10mm口提取。用生理盐水冲洗腹膜,直到洗液变清,在阑尾床或骨盆留下腹膜内引流管。结果:研究共纳入57例受试者,其中女性38例,男性19例,平均年龄26.73±6.5岁,年龄从17岁到50岁不等。所有患者均行诊断性腹腔镜检查,术中表现为阑尾炎穿孔26例(45.61%),坏疽性阑尾炎13例(22.81%),阑尾脓肿11例(19.30%),阑尾肿块7例(12.28%)。平均手术时间49.5±16.86分钟,39 ~ 117分钟。52例(91.23%)患者首选腹腔镜,5例需要开腹手术。住院时间各不相同,2天13例,3天20例,4天17例,5天以上4例。术后随访中,无并发症43例(75.44%),随访超声有发热采集2例(3.51%),有发热未采集5例(8.77%),术后肠梗肠炎2例(3.51%),创面血肿或感染性血肿3例(5.26%)。结论:腹腔镜阑尾切除术可以安全有效地治疗重症阑尾炎。它减少了住院时间和转换。防止术后感染。
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引用次数: 0
¬Knowledge and application of the who safe surgical checklist amongst clinical medical students in a teaching Hospital in north-central, Nigeria: A quantitative analytical study 尼日利亚中北部某教学医院临床医科学生对世卫组织安全手术检查表的了解和应用:一项定量分析研究
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i4a.1021
Daniel David OTOBO, Mary Ehi EKOJA, Nnaemeka Philip UGWU, Obakpororo Henry PALMER, Jacob ADEFILA, Ozioma Bethrand CHUKWU, Mubarak Adewale ISHOLA, Laughter AMAMCHUKWU, Aymar AKILIMALI
This checklist serves as a tool to enhance communication and teamwork among surgical teams, reducing the occurrence of adverse events during surgery. However, its implementation and utilization in some regions especially the LMICs in Africa present unique challenges. This study aimed to explore the knowledge and application of the WHO surgical checklist among clinical medical students in north -central zone of Nigeria. This was done via a single-blinded cross-sectional study among 186 penultimate and final-year clinical medical students at Bingham University Teaching Hospital, Nigeria. We found that 25.8% and 22.6% of the respondents had good and very good knowledge of the WHO Safe Surgical Checklist, respectively. About half of the respondents acquired their knowledge from the classroom alone, while the others were from class lectures and extracurricular activities. The most applied component of the surgical checklist was the sign-in (61.3%), followed by the sign-out (38.7%), while the time-out was the least (32.2%). While the general surgeons (36%) and the obstetricians and gynecologists (29%) were the most likely to adhere to the safe surgical checklists in their procedures, the orthopaedics surgeons were the least likely (3%). While the sign-in remains the most applied component of the checklist, with time-out being the least, we should know that each component has its safety potential.
此检查表可作为加强手术团队之间沟通和团队合作的工具,减少手术过程中不良事件的发生。然而,在一些区域,特别是非洲的中低收入国家,它的实施和利用面临着独特的挑战。本研究旨在探讨尼日利亚中北部地区临床医学生对WHO手术检查表的了解和应用情况。这项研究是通过一项单盲横断面研究在尼日利亚宾厄姆大学教学医院的186名倒数第二年和最后一年的临床医科学生中完成的。我们发现,25.8%和22.6%的受访者分别对世卫组织安全手术清单有良好和非常好的了解。大约一半的受访者从课堂上获得知识,而其他人则从课堂讲座和课外活动中获得知识。手术检查表中应用最多的是签到(61.3%),其次是签到(38.7%),而暂停(32.2%)最少。普通外科医生(36%)和妇产科医生(29%)最有可能在他们的手术中遵守安全手术清单,而骨科医生的可能性最低(3%)。虽然登录仍然是检查表中应用最多的组件,而超时是最少的,但我们应该知道每个组件都有其安全潜力。
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引用次数: 0
Management of abdominal surgical emergencies at the Labe regional hospital (guinea) 在Labe地区医院处理腹部外科急诊(几内亚)
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3b.1011
Ansoumane Condé, Mariama Camara, Thierno Souleymane Bah, Djiba Camara, Fode Cisse, Labilé Togba Soumaoro, Aboubacar Touré
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引用次数: 0
A novel approach in diagnosis and treatment of oral cancer 口腔癌诊断与治疗的新方法
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i1a.970
D. Sabea, Sumayah Al-Mahmood, H. M. Salih
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引用次数: 1
Local vancomycin in prevention of surgical site infection in spinal surgeries 万古霉素在脊柱手术中预防手术部位感染的作用
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i4b.1032
Moustafa Fouad Eltarras, Waleed Mohammed Ewis, Mohamed Osama Ramadan, Osama Ali Elgebaly
Background: Organisms that cause surgical site infections (SSIs) can no longer be effectively prevented by antibiotic drugs due to resistance. Methicillin-resistant Staphylococcus aureus (MRSA) SSIs have become more prevalent to cure. Lyophilized vancomycin powder has been used locally as perioperative prophylactic antibiotics, right before the surgical wound is closed. The study's objective was to evaluate the local vancomycin administration to SSI prevention during spine operations.Methods: This randomized trial study was conducted on 42 patients above 18 years old who were subjected to lumbosacral, thoracic, or cervical open spinal surgery The patients were split into 2 groups: Treatment group: this group receives local application of vancomycin and placebo group: this group not get any topical antibiotics. Results: The ESR level at follow-up time post operatively there was no significant differences at any groups. However, there were reduction of ESR level in the treatment group. There were differences in CRP level between 2 groups at 10 days, 2weeks, and 8 weeks. In the treatment group we found most of our cases 13 (62%) with category A. There are 7 cases (33%) in category B and one case with category C. In the placebo group, we found most of our cases 11 (52%) cases with category A. There were 6 cases (29%) cases in category B and the remaining 3 cases (14%) of category C.Conclusions: We found that old age and diabetic patient should be applied with vancomycin. Ultrasound scan and MRI are a good way to detect infections. These outcomes suggest that using vancomycin intraoperatively reduced the incidence of SSIs following spine operations.
背景:引起手术部位感染(ssi)的微生物由于耐药已不能被抗生素药物有效预防。耐甲氧西林金黄色葡萄球菌(MRSA) ssi已经变得越来越普遍。冻干万古霉素粉剂被局部用作围手术期预防性抗生素,就在手术伤口关闭之前。该研究的目的是评估脊柱手术期间局部使用万古霉素预防SSI的效果。方法:对42例18岁以上腰骶、胸、颈开放性脊柱手术患者进行随机试验研究,将患者分为两组:治疗组局部应用万古霉素,安慰剂组不外用抗生素。结果:两组患者术后随访时ESR水平无明显差异。而治疗组的ESR水平有所降低。两组在10天、2周、8周时CRP水平有差异。治疗组13例(62%)为a类,B类7例(33%),c类1例;安慰剂组11例(52%)为a类,B类6例(29%),c类3例(14%)。结论:老年及糖尿病患者宜应用万古霉素。超声扫描和核磁共振成像是检测感染的好方法。这些结果表明,术中使用万古霉素可降低脊柱手术后ssi的发生率。
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引用次数: 0
Novel presentation of idiopathic benign retroperitoneal cyst: A case report 特发性良性腹膜后囊肿的新表现:1例报告
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i1a.964
Dr. Sumesh Ramesh Doiphode, D. M. Tripathi, Dr. Rohit Rajeshkumar Singh, Dr. Bhushan Thakare, Dr. Tasvir Balar, Dr. Lakshay
Benign cystic lesions of the retroperitoneum and mesenterium are rarely encountered clinically 1, 2 . Up to 40% of such cysts are found incidentally during abdominal surgery for unrelated disorders 1 . Most patients display some chronic symptoms that necessitate therapeutic intervention. CT scan might help in confirming the diagnosis and surgery is the mainstay treatment. This report describes a case of a giant retroperitoneal cyst successfully excised in an adult female.
腹膜后和肠系膜的良性囊性病变在临床上很少见1,2。高达40%的此类囊肿是在不相关疾病的腹部手术中偶然发现的。大多数患者表现出一些需要治疗干预的慢性症状。CT扫描可能有助于确诊,手术是主要的治疗方法。本报告描述一例成功切除的成年女性腹膜后巨大囊肿。
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引用次数: 0
期刊
International Journal of Surgery Science
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