Background: Gallstones are the major cause of morbidity and mortality throughout the world. With at least 10 % of the adults have gallstones with a recent rise in the incidence due to change in the dietary factors. This study intends to know its various modes of presentation, treatment, outcome. Methods: Fifty patients with symptoms and signs of cholelithiasis admitted in surgical 'B' unit, Government Medical College -A Tertiary care hospital, Mysuru from period of January 2012 to July 2013, were included in the study, clinical profile, investigation, treatments, outcomes were analysed. Results: The highest age incidence of cholelithiasis was in the 5 th decade, more common in females. Pain abdomen was the most common symptom. Ultrasonography showed gallbladder stones in all patients and 52% of patients undergone open cholecystectomy, 48% of patients undergone laparoscopic cholecystectomy. The conversion rate of lap to open cholecystectomy was 4%. The operating room time and the length of post-operative stay were 65 min and 7 days in open cholecystectomy and 115 min and 3 days in lap cholecystectomy. Conclusions: The result showed cholelithiasis was more common in females, 5 th decade, presented most commonly with pain abdomen. Ultrasonography was the most common investigation. Laparoscopic cholecystectomy reduces the number of hospital days, pain, disability.
Background: Gastric Outlet Obstruction implies complete or incomplete obstruction of the distal stomach, pylorus or proximal duodenum. Gastric outlet obstruction is not a single entity; it is the clinical and pathophysiological consequence of any disease process that produces a mechanical impediment to gastric emptying. Now in the era of H2 blockers and proton pump inhibitors, incidence of duodenal ulcer producing gastric outlet obstruction has been decreasing as symptomatic ulcer begin to respond to medical treatment, and at the same time the incidence of antral carcinoma of stomach producing gastric outlet obstruction has comparatively increased, which may be due to increased early diagnosis of the condition with the help of flexible fibre optic endoscope. Methods: An elaborate study of these cases with regard to the history, clinical features, routine and special investigations, pre-operative treatment, operative findings, post-operative management and complications in post-operative period is done. Results: Of the 50 cases of gastric outlet obstruction 26 had carcinoma antrum (52%), 23 had cicatrized duodenal ulcer (46%) and 1 had gastric outlet obstruction secondary to corrosive ingestion. The age incidence of the patients in this study ranged from 22 -84 years with a mean of 53.62 years. In case of obstruction secondary to duodenal ulcer the maximum age incidence is between 31-40 years. The maximum age incidence of gastric outlet obstruction due to carcinoma antrum is 61-70 years. In this series, 42 patients (84%) were males and 8 patients (16%) were female. Male to female ratio (M:F) is 5.25:1. M: F ratio in cicatrized duodenal ulcer is 10.5:1 and in carcinoma antrum is 3.33:1. 52% of the patients were manual labourers who gave a history of irregular diet habits. 68% of patients had history of smoking and 66% had history of alcohol intake. Postprandial vomiting and epigastria pain are the main symptoms (96%) in this series. Other symptoms included anorexia (84%), weight loss (72%), post prandial Epigastric fullness (68%), haematemesis (24%), melena (64%) and constipation (48%). Pallor was present in 56% and dehydration in 62%. Blood group 'O' was common in cicatrized duodenal ulcer patients (52.18%) whereas blood group 'A' was common in malignant cases (50%). Conclusions: Number of cases with cicatrized duodenal ulcer as the chief etiological factor for gastric outlet obstruction is diminishing and the number of cases of antral carcinoma of stomach as the cause of gastric outlet obstruction is increasing. Upper Gastro intestinal endoscopy should be mandatory in all suspected cases of gastric outlet obstruction. It can diagnose the cause of obstruction very effectively than any other investigative modality. Effective treatment in carcinoma stomach depends on early diagnosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.