A 56-year-old man presented with massive right haemothorax 10 days following percutaneous nephrolithotomy (PCNL) for complex, large-bulk, right renal stones. Antiplatelet medication started following coronary stenting 7 months ago was stopped 5 days prior and resumed 2 days following surgery. Stones were cleared through two tracts, one supracostal, with placement of ureteral stent but no nephrostomy. He was discharged the next day with an unremarkable chest X-ray. He developed cough and fever after 1 week. Three days later he presented with acute dyspnoea, blood pressure of 100/60 mm Hg, pulse of 120/min and haemoglobin of 9.0 g/dL. Chest X-ray and CT scan showed a large right haemothorax. Two-litre haemothorax was drained by intercostal drainage with prompt recovery. Haemothorax is a rare complication following PCNL usually after supracostal access. Most occur at or immediately following surgery. Infection and early resumption of antiplatelet medication might have contributed to his presentation with delayed secondary haemorrhage from a pleural injury.
Megalourethra is a rare congenital disorder of anterior urethra and erectile tissue of penis. It mainly appears in two types—a milder scaphoid type and severe fusiform type. Fusiform type is commonly associated with congenital anomalies of various systems of the body. Isolated megalourethra without other congenital anomalies is extremely rare. We report one such case which was detected postnatally and successfully treated by reduction urethroplasty.
Introduction: Bilateral vocal cord paralysis is a rare but dangerous condition which results in shortness of breath and poor quality of voice. Only patients with severe bilateral vocal cord immobility require surgical intervention. In the present study, we describe the procedure of combined endoscopic and external surgical approach for lateralization of vocal cord in bilateral abductor palsy.
BACKGROUND Caesarean section is a very commonly done lifesaving procedure. Despite being that common, surgical techniques and steps do widely vary. The most common complications of caesarean section are superficial surgical site complications including sepsis, seroma formation, partial/ full thickness wound breakdown. The aim of this study was to compare the results of abdominal wound healing of caesarean sections where subcutaneous drain was used with cases where subcutaneous drain was not used. MATERIALS AND METHODS This retrospective cohort study performed on 219 patients was undertaken at Department of Obstetrics and Gynaecology, Sri Adichunchanagiri Institute Of Medical Sciences, from January 2017 to December 2017. The case sheets were retrieved from medical records department and the details were gone through. The number of cases where drain was kept after meeting the inclusion criteria, were 525. The total number of cases where drain was not kept after meeting the exclusion criteria, were 656. Wound induration, wound seroma superficial surgical site infection, post-operative pain, post-operative febrile morbidity, partial or full thickness wound dehiscence requiring dressing and resuturing, duration of hospital stay were tabulated in each wing and compared. RESULTS There was significant difference between group I (without drain group) and group II (with drain group) regarding wound seroma (30 cases without drain versus 5 cases with drain respectively), superficial surgical site infection (25 cases without drain versus 4 cases with drain), full thickness wound gaping (16 cases without drain versus 3 cases with drain), superficial skin break down (40 cases without drain versus 6 cases with drain), postoperative fever (70 cases without drain versus 30 cases with drain). CONCLUSION Patients with drain group have reduced rates of wound seroma, postoperative pain, shorter hospital stay, wound breakdown, but there is insignificant benefit regarding post-operative fever, superficial surgical site infection and haemoglobin concentration.
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