Background: Abdomen is the third most common organ injured following extremities and head injury. CT scanning has increased the identification of injuries. The care of the trauma patient is demanding and requires dedication, diligence, and efficiency. To evaluate the type and frequency of injury of various intraabdominal organs in the blunt trauma of the abdomen.Methods: After a primary survey of these patients, brief history and complete physical assessment all the basic investigations were done. Skiagrams were taken routinely. Ultrasonogram (F.A.S.T SCAN) was done for all cases and a CT scan was done for selected cases.Results: Road traffic accident was the most common mode of injury accounting for 76% cases. 36% of the cases were in the third decade of their lives. Spleen was the most common injured organ accounting for 52% of the cases.Conclusions: Solid organs like spleen and liver were more commonly injured in blunt injury to abdomen than the other organs like mesentery, retroperitoneum, bladder etc.
A 57 years old male who was a known case of type 2 diabetes presented with a swelling over the left lower abdomen and groin. The patient appeared toxic and local examination revealed discoloration of size 8x6 cm over the groin with a 1×0.5 cm sized ulcer over it accompanied by a seropurulent discharge. A clinical diagnosis of necrotizing fasciitis was made and investigations revealed an elevated blood sugar, white count and creatinine with cultures showing a poly-microbial growth. Emergency debridement under IV sedation was done and subsequently patient underwent daily debridement and dressing in addition to antibiotics and adequate glycemic control. This condition is a surgical emergency and early diagnosis is crucial for improved prognosis. Aggressive surgical debridement is the first line treatment followed by specific antibiotic therapy.
Achalasia cardia is a motility disorder where there is aperistalsis of the body of the esophagus and failure of lower esophageal sphincter relaxation. This manifests as a functional gastroesophageal junction obstruction. This disorder is rare and has a prevalence of 10 in 100,000 population. It has a peak incidence between 30-60 years of age. The incidence in the pediatric population is very low and is even rarer in infants. Here we present a case of achalasia cardia in a 9-month-old male infant weighing 3.1 kilograms. The child had complaints of regurgitation of milk, non-projectile vomiting, fever and cough for the past 3 months along with failure to thrive. He was treated for bronchopneumonia initially and then evaluated with a barium swallow. The barium swallow revealed a hold-up of contrast in the distal esophagus along with a typical bird-beak appearance. Definitive surgical intervention was being planned. However, the child aspirated and expired. Did we delay the procedure? Were we too late? These questions continue to make us self-introspect on the management of infantile achalasia cardia. The paucity of available publications and data is a major roadblock in management.
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