Background: the aim of the study was to study the clinical presentations, modes of management and outcome in a patient with splenic trauma. Setting and design of study retrospective observational study conducted in a tertiary care hospital in GMC Jammu.Methods: The study was done in the department of general surgery in a tertiary care centre that has round the clock availability of all radiological investigations. A total 50 cases of splenic trauma diagnosed by focussed abdominal sonography in trauma (FAST) or CT scan or per operatively were enrolled in the study.Results: Maximum number (36%) of patients were aged between 31-40 years of age. Most of the patients (92%) presented with blunt abdominal trauma. RTA (40%) and fall (40%) were the common causes of blunt abdominal trauma. Maximum patients (36%) had grade III splenic injury.30% of the patients managed by NOM while 70% underwent splenectomy.Conclusions: Patients with splenic injury (grade I-grade III) can be managed by NOM without increased morbidity and mortality through proper monitoring.
Background: Repair of hernia has seen a paradigm shift from open technique to laparoscopic technique. Laparoscopic transabdominal preperitoneal mesh hernioplasty is the latest technique with several advantages over open repair. Polypropylene (PP) mesh is the most frequently preferred product, as are easily and cheaply available, provide enough strength for the technique with good biocompatibility and less tissue reaction. Objective was to study the outcome of usage of polypropylene mesh in TAPP hernia repair. Methods: It was a prospective study on patients with diagnosis of inguinal hernia and underwent TAPP hernia repair with polypropylene mesh. Results: Total of 60 patients were included. Majority of the patients (18; 30%) were in age groups of 46-55 years and 56-65 years. 67% cases of inguinal hernia were of indirect type, 30% direct type and 3% both direct and indirect. Right-sided inguinal hernia (57%) was more frequent, followed by left sided (23%) and bilateral (20%). Average time taken was 72 to 98 minutes with a mean of 81.33 minutes in the surgery for unilateral repair and 90 to 103 minutes with a mean of 97.66 minutes for bilateral repair. 40 (67%) patients returned to work within 2 weeks of surgery. Conclusions: Inguinal hernia repair is a common surgical procedure performed on daily basis around the world. Delay in treatment can lead to complications. Laparoscopic approach has shown clear advantages regarding less postoperative pain, numbness, fast return to normal activities and decrease in the incidence of wound infection and hematoma. Polypropylene has proven physical, chemical and biological properties and is currently the most widely used allograft in laparoscopic inguinal hernias.
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