INTRODUCTIONIncisional hernia is a common surgical condition encountered in day to day practice. It is most often seen in obese individuals. Based on national operative statistics, incisional hernias account for 15% to 20% of all abdominal wall hernias. Of all hernias encountered, incisional hernias can be the most frustrating and difficult to treat. Incisional hernias occur as a result of excessive tension, postoperative abdominal distension and inadequate healing of a previous incision, which is often associated with surgical site infection, persistent postoperative cough, infection. Several technical and patient-related factors have been linked to the occurrence of incisional hernias. There is no conclusive evidence that demonstrates that the type of suture or technique of incisional closure at the primary operation affects hernia formation. 1Primary repair of incisional hernias can be done when the defect is small (≤2 cm in diameter) and there is viable surrounding tissue. Larger defects (>2-3 cm in diameter) have a high recurrence rate if closed primarily and are repaired with a prosthesis. Recurrence rates vary between 10% and 50% and are typically reduced by more than half with the use of prosthetic mesh. Prosthetic material ABSTRACT Background: Incisional hernia is a common surgical condition accounting for 15% to 20% of all abdominal wall hernias. Of all hernias, they can be the most frustrating and difficult to treat. Several technical and patient-related factors have been linked to their occurrence. There is no conclusive evidence that demonstrates that the type of suture or technique of incisional closure at the primary operation affects hernia formation. Recurrence rates (10-50%) and are typically reduced by more than half with the use of prosthetic mesh. People of all ages and ethnic backgrounds may develop an incisional hernia after abdominal surgery. This study was an effort to evaluate the risk factors, clinical presentations and polypropylene mesh repair (pre-peritoneal) management of incisional hernia. Methods: A total of 50 patients having incisional hernias admitted in our hospital between 2009 to 2011 have been studied. Strangulated, incarcerated, unfit patients with recurrent hernias and pregnancy have been excluded. Preperitoneal mesh repair was done in all the patients and follow up was done for 2 years. Results: Incisional hernia is more common in the obese and in middle aged females. Common risk factors are post op infection, obesity and multiparity. Most of the patients had incisional hernia within a year of previous surgery. Conclusions: Females are more prone. Most patients present as abdominal swelling with cough impulse and reducible on lying supine. Most of them occur within a year of previous surgery. Common risk factors include obesity, post op infections and multiparity.
Hernia is commonly operated in surgical department either emergency basis or as elective case. Unusual contents of hernia sac are uncommon, but are likely to be encountered by a surgeon in his career due to the frequency of hernia repair. The presence of vermiform appendix in inguinal hernias, referred to as Amyand's hernia, is rare occurring in about 1% of inguinal hernias. This is to present our experience of unusual contents in inguinal hernia sac. Amyand's hernia is not very often seen in the clinical practice and its pre-operative diagnosis is very difficult hence awareness of this disease condition is essential for pre-operative suspicion and even diagnosis of the condition.
Background: Acute appendicitis is one of the commonest conditions treated at emergency, despite of advances in diagnostic medicine and therapeutics, the diagnosis of appendicitis remains essentially clinical, requiring clinical acumen and surgical knowledge. Maximum incidence noted in second and third decade of life with male predominance. Ultrasonograpy is shown to be effective in the diagnosis of acute appendicitis with a sensitivity of 84 to 89% and specificity of 92 to 98%. Objectives of the study was to study the clinical features of acute appendicitis regarding Alvarado score. Role of USG and HPE Examination in supporting the clinical diagnosis of acute appendicitis and the morbidity, mortality of emergency appendicectomy.Methods: 100 patients who were admitted to VIMS hospital, Bellary, from November 2004 to April 2006 with a clinical suspicion of acute appendicitis were included in the present study. Ultrasonography and Histopathological Examination was done in all cases and results were correlated with final analysis. Results were analyzed using 'Z’ test, Chi-squire test, sensitivity and specificity.Results: In present study of 100 cases 77 were males and 23 Females patient. Out of which 60 are in 15 to 30 years, 21 patients are 10 to 15 years followed by 13 in the age group of 30-40 years. All are undergone appendicectomy. 11 patents undergone Elective, and 89 emergency appendicectomy. Ultrasound was coming positive in 92 cases and negative in 8 cases. The sensitivity and specificity of 95.7% and 80% Respectively. HPE was done in all 100 cases 95 were positive 5 were negative with sensitivity of 96.8% and specificity of 80%.Conclusions: Appendicitis is commonest in 2nd and 3rd decade followed by 4th decade with a male preponderance, Ultrasonography is useful in females to rule out any gynecological pathology. Patients who come early within 2 to 3 days of symptoms of acute appendicitis, emergency appendicectomy is the treatment of the choice and were will be less morbidity and mortality, post operatively.
Background and objectives: Breast lumps diseases are one of the most common diseases in India which include congenital, traumatic, inflammatory, hormonal mastopathy, benign and malignant neoplastic conditions. Around 200,000 cases of breast diseases are diagnosed annually. The purpose of present study was to assess the role of ultrasound and Fnac in the diagnosis of breast lesions and the various modes of management. Method: Fifty cases of benign breast diseases were studied during the period from June 2017to May 2018. Result: In the present study USG has an accuracy of 77.78% for detection of Fibroadenoma and 66.67% for Cystosarcoma Phyllodes. FNAC forms the major investigatory modality with fair accuracy of 91.67% present to diagnose fibroadenoma and 66.67% for Cystosarcoma phyllodes. Intracanalicular type of fibroadenoma was the most common type of fibroadenoma on Histopathological report (83.33%). Surgical excision is the effective treatment for most of the benign breast disease nearly upto 90% cases. Wide excision and simple mastectomy needed rarely. Conclusion: FNAC is a most accurate, safe, cost effective and easy method to confirm the diagnosis of most benign breast disease with good sensitivity.Surgical Excision is the main stay of treatment for most benign breast diseases
Background and Objectives: Benign breast disease are commonly found as painless palpable mass the diagnosis may be corroborated with specific benign features found on physical examination, mammography and ultrasound. The purpose of present study was to assess the various age of presentation of benign breast diseases and their mode of presentation. Method: Fifty cases of benign breast diseases were studied during the period from June 2017to May 2018. Result: In all benign breast disease Fibroadenoma is most common with presenting mainly in the age group of 11-20 years. All cases of benign breast disease presented with lump (100%) out of them 80% presented with painless lump and 20% presented with painful lump. In present study 96% were premenopausal and 4% were postmenopausal woman. Most common site of involvement was left breast and most common quadrant was upper outer quadrant. Conclusion:Benign breast disease present mainly 11 -30 year of age group. Most common clinical presentation in benign breast disease is lump (painless). Majority of benign breast disease involve upper and outer quadrant of breast. Lymph node involvement in benign breast disease is rare.
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