Background: Port site complications are bothersome complications which undermine the benefits of minimal invasive surgery, not only does it add to the morbidity of the patient but also spoil the reputation of the surgeon. Aims and objective of the study was to determine the morbidity associated with the port site complications in laparoscopic surgery and to identify risk factors for complications.Methods: Three hundred patients having age between 15-50 years admitted for elective laparoscopic procedure were studied. All the patients had preoperative workup and general anaesthesia was given with endotracheal intubation. The patients were observed for any port-site complication during operation and in the immediate and postoperative till three months.Results: Female preponderance (77.34%) was observed with maximum patients belonging to age group of 41-50 years (31.7%). Majority of the patients were in the BMI range of 18.5-25kg/m2 (53.33%). In 54.66% and45.33% patients Verres needle and Hasson’s (Open) method was used to create pneumoperitoneum. Cholecystectomy was the indication in 80% patients. Port site morbidity was observed in 8.67% patients. As an early port site complication, bleeding, surgical site infection, emphysema and visceral injury was observed in 6, 8, 4 and 1 patient respectively. As a late port site complication, 4 and 3 patients developed hernia and hypertrophic scar respectively.Conclusions: Port site complications are least in elective laparoscopic surgery.
Abdominal hydatid cyst disease mostly involves the liver. Involvement of the pancreas as an isolated primary organ is rare accounting for < 2% of all systemic echinococcosis cases. It mostly involves the head of the pancreas. Symptoms depend on the location, size, and associated complications; therefore, it can have varied presentations including acute pancreatitis. On imaging, it can mimic other common pancreatic cystic lesions like pseudocyst or cystic neoplasm. Accurate preoperative diagnosis is usually difficult and requires a very high index of suspicion even in endemic areas. Herein, a case of primary isolated hydatid cyst of the pancreas that was initially diagnosed and managed as acute pancreatic pseudocyst is reported.
BACKGROUND Abdominal tuberculosis has been a common disease that poses challenge for the diagnosis of disease, as vague symptoms of the disease always lead to delay in diagnosis. This disease can be called as an imitator of other abdominal pathologies. A high index of doubt is necessary to make early and accurate diagnosis. Abdominal involvement can occur in body at various places like gastrointestinal tract, solid viscera, peritoneum and lymph nodes. Numerous investigations have to be used to help in making the accurate diagnosis of abdominal tuberculosis. Accurate diagnosis in early pathogenic stage and starting of antitubercular therapy and surgical treatment are important to prevent complications leading to morbidity and mortality of patients. Patients having long term symptoms are often weak debilitated, anaemic, malnourished, chronically ill and underweight which may be due to cachexia. METHODS This is a prospective observational study conducted from March 2016 to March 2018, in Mahatma Gandhi Medical College Associated M.Y. Hospital, among 47 patients with a diagnosis of abdominal tuberculosis confirmed histopathologically. RESULTS Maximum patients in our study belonged to 20 to 40 yrs. age group. 27% were males and 72 % were females. 8% patients were treated conservatively and 91 % patients were offered operative treatment. Majority of patients presented with symptoms of abdominal pain (85%), abdominal distension (85%), vomiting (74%), weight loss (74%), fever (17%), alteration in bowel habits (21%) and lump in abdomen (6%). Most common findings were of primary perforations (68%), adhesions (46%), plastered abdomen (34%), ileocecal mass and ileocecal junction perforation (6%). Ileal and jejunal strictures were minor findings. In majority of patients, ileostomy (83%) was performed as life saving measure, adhesiolysis was done in 68%, primary closure of perforation (25%), resection and anastomosis (8.5%). CONCLUSIONS Since the clinical presentations of abdominal tuberculosis are very non-specific and vague and the diagnostic criteria are limited, diagnosis has to be supported by additional tests and by retrospective analysis with reference to clinical patterns and underlying diseases. We also emphasize the importance of histopathological examination in establishing the diagnosis in poor resource settings.
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