Acute necrotizing gastritis with gangrene of the stomach wall is a rarely encountered condition. This often a fatal condition if is attributed to vascular occlusion, chemical and mechanical injuries or infectious etiologies. We review the available literature with a case of acute necrotising gastritis with unknown etiology. Case was managed successfully with emergency partial gastrectomy.
Paraduonenal hernia constitutes more than 50% of internal hernia cases. It can result in perilous sequelae like gut ischemia and perforation. We report a case of a patient who presented with acute intestinal obstruction and peritonitis and was diagnosed as a case of complicated paraduodenal as an incidental finding on laparotomy.A 26-year-old male patient presented with three days history of continuous severe incapacitating diffuse abdominal pain. The pain was associated with multiple episodes of bilious vomiting and absolute constipation. Patient had signs and symptoms of shock. Abdomen examination showed generalized peritonitis. Patient had deranged laboratory investigations. Abdominal X-ray showed acute intestinal obstruction. Patient was resuscitated and taken up for emergency laparotomy. Intraoperatively there was a long segment of gangrenous small bowel entrapped in the paraduodenal sac. Gangrenous gut was released from the sac and excised with proximal and distal ends fashioned as stoma through separate sites. Patient was managed with intravenous fluids with total parental nutrition. Patient gradually started on oral diet and jejunostomy output was refed through the distal stoma. Patient was discharged on postoperative day 14. Patient had uneventful early stoma closure at postoperative day 45 and now is on regular follow-up in the outdoor department.Paraduodenal hernias are one of the rare causes of intestinal obstruction that is difficult to diagnose. Radiologic investigation like abdominal computed tomography (CT) scan can aid in diagnosis of paraduodenal hernia. Surgeons should have clear knowledge about abnormal anatomy of internal hernias and complications they can face during surgery.
Scrotal trauma is a rare surgical emergency. Blunt trauma scrotum is a common mode of scrotal injury which may result in testicular rupture, haematocele, testicular dislocation and hematoma. Testicular injuries are managed both conservatively as well as surgically. Surgical exploration becomes a must in case of testicular rupture and large haematoceles.
Amoebic colitis is a common infection in all population groups across all geographical barriers and is an easily treatable disease in its routine manifestations. However, he has its set of complications that carry poor prognosis. Amoebic liver abscess is a common complication but its association with caecal perforation is rare, and carries worst prognosis. No survivors have been documented in the available literature and the result was pretty much the same in our study.
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