ABSTRACT:Phytobezoars are an unusual cause of small bowel obstruction (SBO). We report 14 patients presenting with episodes of small bowel obstruction from phytobezoars. 14 patients were admitted with SBO due to diospyrobezoar. 21.4% patients were females and majority belonged to rural areas. Majority were admitted to the hospital in November and December, when the fruit is highly consumed. Ileum was the commonest site for the location for phytobezoars (50%) followed by jejunum (28.6%). All patients underwent surgery including manual fragmentation and milking into cecum in 50% patients, enterotomy in 21.4% patients, resection anastomosis in 14.3% patients and resection with exteriorization of gut in 14.3% patients. Phytobezoars including diospyrobezoar should be considered as a rare but important cause of small bowel obstruction in children and in adults with known risk factors hailing from rural areas. Surgical treatment with manual fragmentation and milking of bezoar into cecum is effective in most cases.
Patients of pyogenic liver abscess usually present with right upper quadrant pain, fever, nausea and vomiting.
ABSTRACTBackground: Pyogenic Liver abscesses are potentially life threatening if left untreated. They pose a major Diagnostic and therapeutic challenge to modern world. Interventional radiology is becoming standard of care for liver Abscesses. Methods: All patients of pyogenic liver abscess admitted to Government Medical College and hospital Jammu, J and K, India from October 2018 to November 2019 were prospectively studied. Demographics, presentation, lab reports and management strategies were evaluated. Results: Total of 60 patients of pyogenic liver abscesses were studied with 81.7% males. Alcohol was found to be most common risk factor with 55% of patients being alcoholic. Right lobe of liver was involved in 66.7% of patients. Segment VI and VII were involved in 50% of patients. The most common clinical symptom was right upper quadrant pain (98.3%), followed by fever (91.7%). The most common clinical sign was right upper quadrant tenderness (91.7%). Percutaneous drainage with catheter placement was the most common and successful modality of management associated with least hospital stay. Conclusions: Pyogenic liver abscess is a rare but serious problem. Early diagnosis and treatment are necessary to avoid mortality. Percutaneous drainage along with I.V antibiotics is the best form of management.
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