INTRODUCTIONBurst abdomen (abdominal wound dehiscence) is a severe post-operative complication. Incidence as described in literature ranges from 0.4% to 3.5%.1 Burst abdomen is defined as post-operative separation of abdominal musculo-aponeurotic layers, which is recognised within days after surgery and requires some form of intervention.Various risk factors are responsible for wound dehiscence such as emergency surgery, intra-abdominal infection, malnutrition (hypoalbuminemia, anaemia), advanced age, systemic diseases (uraemia, diabetes mellitus) etc.2 Good knowledge of these risk factors is mandatory for prophylaxis. 3Patient identified as being high risk may benefit from close observation and early intervention.The study aims to find etiological factors of burst abdomen in hospitalised patients, evaluate current management methods and to compare conservative and operative approach with respect to complication and outcomes. ABSTRACTBackground: Burst abdomen (abdominal wound dehiscence) is a severe post-operative complication. Burst abdomen is defined as post-operative separation of abdominal musculo-aponeurotic layers. The study aims to find etiological factors of burst abdomen in hospitalised patients, evaluate current management methods and to compare conservative and operative approach with respect to complication and outcomes. Methods: All cases presenting with abdominal wound dehiscence after surgery were included. An elaborate clinical history was taken in view of the significant risk factors, the types of surgery performed, type of disease involved and management methods and their outcome. A total of 82 cases were included in this prospective study. Data was analyzed using appropriate software. Results: The results concluded that male patients have a higher incidence of laparotomy wound dehiscence and in 5
Background: Acute intestinal obstruction is one of the major surgical emergencies. Intestinal obstruction is defined as partial or complete interference with forward flow of small or large intestinal contents. Intestinal obstruction of either small or large bowel continues to be a major cause of morbidity and mortality. Study aims to find the aetiology, diagnosis and management of acute intestinal obstruction.Methods: A total of 135 patients of acute intestinal obstruction was studied from November 2013 to October 2015 in government medical college, Nagpur. Study was done in patients in OPD of this tertiary centre. Inclusion criteria being patients coming to the hospital with features suggestive and further confirmed of acute intestinal obstruction. Patients included were in, age group of 18 years to 80 years giving written informed consent. Patient of pseudo obstruction were excluded from the study.Results: A total of 135 patients, presented with acute intestinal obstruction during the period of the study. Mean patient age was 45.87 years with peak incidence in those aged 21-30years. The foremost signs and symptoms were constipation (85.93%) and abdominal pain (91.11%). Adhesions and bands (61.9%) was the leading causes of intestinal obstruction.Conclusions: Present study concluded that small bowel obstruction is more common than large bowel obstruction. Abdominal pain, constipation and distension are the most common symptoms, while increased bowel sounds, tachycardia and tenderness is most common sign. Post-operative adhesion in small bowel and malignancy in large bowel is major cause of acute intestinal obstruction.
Medullary carcinoma is an infrequent type of mammary duct carcinoma usually considered to have a better prognosis than common forms of infiltrating duct carcinoma.[1] It constitute less than 5% of all breast cancer. A 48 years old female presented with lump in upper inner quadrant since 6 months. On local examination a lump of size 3*3 cm, painless, soft to firm and mobile, skin nipple areola were unremarkable. No axillary lymphadenopathy .all routine investigation were within normal limit. Radiological examination of chest, pelvis and abdomen showed no evidence of metastasis.Patient underwent modified radical mastectomy with axillary clearance. Specimen sent for histopathological examination turned to be medullary carcinoma breast.
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