Traumatic pseudoaneurysm occurring in face and temple is commonly reported to occur in superficial temporal artery, and so far only four cases have reported involvement of the occipital artery. We report a case of 25-year-old male patient presented to us with a pulsatile swelling in the occipital region following a trauma at the same site 5 years ago. A CT angiogram revealed the pseudoaneurysm of the left occipital artery and was surgically excised after ligation of proximal and distal parts along the course of the occipital artery.
Background: Intestinal anastomosis after resection or following a palliative stoma formation is a very common procedure in India, being a tropical country and hence a large incidence of intestinal perforations as well as rising incidence of malignancies. Volume of procedure being performed all over India suggested us to try some better method of anastomosis as only a few studies have been conducted till now in this part of the world. Methods: The study was conducted among 84 patients [Double layer (group "A") and single layer extra mucosalanastomosis (group "B") groups of 42 patients each] over a period of 2 years. Patients were assigned to either of the groups in a prospective and randomized fashion. Groups were evenly matched by age, sex, diagnosis and location of anastomosis. Patients below 18 and above 60 years age, location of anastomosis other than small bowel and gut wall with oedema, inflammation, ulcers, ischemia, scarring, etc. were excluded from the study. Results: Outcomes as time taken for anastomosis, material cost, anastomotic leak, intra-abdominal abscesses and length of hospital stay were recorded in each group. Time taken and material cost for anastomosis was significantly low in group Bas compared to group A. Postoperative anastomosis leak, intra-abdominal abscess formation and hospital stay, in both the groups, were comparable without significant difference. Conclusions: Single layer extramucosalanastomosis is cost effective and time saving procedure as compared to double layer method without significant difference in postoperative complications.
Background: Acute generalized peritonitis from gastrointestinal hollow viscus perforation is a potentially life-threatening condition. Mannheim peritonitis index (MPI) is a specific scoring system that facilitates early identification of patients with severe peritonitis for aggressive surgical approach and improved outcomes.Methods: A prospective observational study in 60 patients attending surgical emergency unit with perforation peritonitis was conducted to analyse the predictive capacity of MPI. MPI score was categorized into 3 groups: <21, 21 to 29 and >29. Data was compared for predicting mortality and morbidity. P value, chi square test and 95% CI were used as statistical tools.Results: Two thirds of 60 patients studied were younger than 50 years of age. Prognosis was poorer in patients above 50 years with age. 80% presented after 24 hours. Ileal perforation was the commonest etiology. Morbidity and mortality were worst in patients with MPI score >29.Conclusions: Mannheim peritonitis index is disease specific, easy to apply and effective scoring system predicting the outcome in perforation peritonitis, with increasing MPI score being directly proportional to higher mortality and morbidity of the patient.
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