{"title":"An inguinal surprise: strangulated femoral hernia","authors":"Syed Saad, Mansoor Ahmed, Milind H. Iddalagi","doi":"10.18203/2349-2902.isj20240594","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240594","url":null,"abstract":"Femoral hernias account for 2% to 4% of groin hernias, are more common in women, and are more appropriate to present with strangulation and require emergency surgery. This condition may lead to symptoms of bowel obstruction or strangulation and possible bowel resection-anastomosis. There are few reports of strangulated femoral hernia. Femoral hernias, often, are usually delegated to a secondary differential or if even rarer not considered at all during dubious presentations as groin swellings which are irreducible without the classical features which have usually been described in our surgical literatures, Inguinal being forefront for diagnosis. We herein present a 45-year-old female had come to the outpatient department at MVJ MC and RH with the complaints of swelling in the left groin for 5 years and pain for 8 days sudden onset with irreducibility, with no features of small bowel obstruction. She was diagnosed as having a left side obstructed inguinal hernia after appropriate radiological investigations and underwent inguinal exploration. Intraoperative diagnosis of left sided strangulated femoral hernia with omentum as its content was made. Omentectomy with herniorrhaphy was done and post-operative period was uneventful, and patient was discharged with regular follow up. Femoral hernias are more common in women and lead to a substantial over risk for an emergency operation, and consequently, a higher rate of bowel resection and mortality. Femoral hernias should be operated with high priority to avoid incarceration and be repaired with a mesh.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"2014 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140416353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Pratap, Ali Abbas Sayed, Manoj Kharade, Prakash Pawar, Ajit Sawant, M. H. S. Ahmed, Raunak Shewale, Umang Trivedi, Sanjay Dange, Jaydeep Dalvi, Amit Chiddarwar, Sanket Chaudhari
{"title":"An observational study of predictive factors for fever and sepsis following percutaneous nephrolithotomy","authors":"V. Pratap, Ali Abbas Sayed, Manoj Kharade, Prakash Pawar, Ajit Sawant, M. H. S. Ahmed, Raunak Shewale, Umang Trivedi, Sanjay Dange, Jaydeep Dalvi, Amit Chiddarwar, Sanket Chaudhari","doi":"10.18203/2349-2902.isj20240568","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240568","url":null,"abstract":"Background: Although percutaneous nephrolithotomy is considered a safe procedure, it is not without complications. Certain preoperative and intraoperative factors if not identified and adequately treated in time can lead to complications ranging from post operative fever to urosepsis which may seldom lead to mortality. The aim of our study is to identify those factors so as to prevent complications and promote patient safety.\u0000Methods: Retrospective analysis of medical records of the patients undergoing PCNL from January 2020 to January 2023 was done. A total of 235 patients were included in the study and associated factors analyzed statistically. Statistical analysis was performed by Chi-square test.\u0000Results: We found five factors which significantly correlated with postoperative sepsis, namely, stone size >30 mm, staghorn calculus, prolonged operative time >120 min, significant bleeding requiring transfusion and pre operative urine culture positive.\u0000Conclusions: Sepsis following PCNL is not uncommon. Progression to urosepsis maybe life threatening. Decreasing operative time decreases bleeding and related complications as well. Prophylactic antibiotics is recommended in PCNL procedure owing to its clean contaminated/contaminated surgical procedure.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"23 61","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140408864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tshepang A Motsepe, Andrew Machowski, Shaan Marthinus Maritz
{"title":"Diabetic foot and lower limb amputations at tertiary hospitals underscore the need for organised foot health services at primary healthcare level","authors":"Tshepang A Motsepe, Andrew Machowski, Shaan Marthinus Maritz","doi":"10.18203/2349-2902.isj20240599","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240599","url":null,"abstract":"An epidemiological link between diabetes and early mortality has been reported in literature with the cause of death being mainly ischaemic heart diseases. However, a diabetic foot is a common and serious complication of diabetes with a lifetime risk of developing a foot ulcer estimated at 15-25%. Therefore, local (foot disease) and systemic (cardiovascular disease) issues should be attended to in the management of diabetes, and this emphasizes the need for a multidisciplinary team approach. A diabetic foot is defined as worsening sepsis, ulcerations, necrosis or destruction of tissues of the foot in a diabetic patient due to a complex interaction of disorders in the immune function, in the nervous and vascular systems. An improved clinical outcome is associated with wound adjunctive treatments in complementing the standard management protocol which embodies the TIME principles (tissue debridement, infection control, adequate moisture balance to promote tissue granulation in the wound bed and edges of the wound should be free from undermining).\u0000 ","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"13 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ajeet Kumar Singh, P. Nayak, Komal Prasad Dewangan
{"title":"A prospective observational study of predictive factors for conversion of laparoscopic to open cholecystectomy","authors":"Ajeet Kumar Singh, P. Nayak, Komal Prasad Dewangan","doi":"10.18203/2349-2902.isj20240572","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240572","url":null,"abstract":"Background: Cholelithiasis affects about 10 to 15% of general population. LC became the procedure of choice for management of symptomatic gallstone disease for its minimally invasive nature, minimal pain and earlier recovery.\u0000Methods: This study was carried out on 300 consecutive patients who underwent LC for gall stone disease (patients falling under inclusion criteria) in the Department of General Surgery, The Calcutta Medical Research Institute, Kolkata.\u0000Results: In this study 9% patient were converted to open cholecystectomy while 91% of the patient underwent successfully LC. Increased wall thickness of gall bladder (p=0.01), pericholecystic fluid collection (p=0.04), stone impaction at gall bladder neck (p=0.001), pain abdomen (acute cholecystitis, recurrent acute cholecystitis) (p=0.03), previous abdominal surgery (p=0.001), pre-operative jaundice (p=0.005) were found significant in this study for conversion to open surgery. Increased TLC, total bilirubin, alkaline phosphatase, alanine transaminase and aspartate transaminase (p<0.05) were also risk factors for conversion to open surgery.\u0000Conclusions: We conclude that LC is the gold standard treatment for gall stone disease. Identification and safeguarding the bile ducts and arteries is of utmost importance while performing LC.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Marques, Cátia Ferreira, Ricardo Vaz Pereira, G. Guidi, João A. Pinto-de-Sousa
{"title":"Occult small bowel adenocarcinoma in Crohn's disease-more than a simple stricture","authors":"C. Marques, Cátia Ferreira, Ricardo Vaz Pereira, G. Guidi, João A. Pinto-de-Sousa","doi":"10.18203/2349-2902.isj20240582","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240582","url":null,"abstract":"Small-bowel adenocarcinoma (SBA) accounts for less than 5% of all gastrointestinal cancers. It is generally linked to genetic disorders and immune-mediated inflammatory conditions like Crohn's disease (CD). Despite advances in oncology, SBA has a poor prognosis and high relative risk in this subgroup of patients. Risk factors for the development of SBA in patients with CD include a stricture phenotype and a long- standing disease. This article aims to expose a case of association between CD and SBA and its management. A 66-year-old woman with long-standing terminally ileum-affected CD with multiple admissions due to sub-occlusive episodes and weight loss. CT and MRI revealed intestinal thickening in the small bowel, suggesting an inflammatory stenosis and entero-enteric fistulous tracts. An ileocolectomy was performed, and the patient's histopathological evaluation revealed a mucinous invasive adenocarcinoma of the terminal ileum. The patient was treated with adjuvant chemotherapy and has been under surveillance for two years, without malignant recurrence. Although it is a relatively rare neoplasm, CD patients have a significant risk of developing SBA, when compared to the general population. Diagnosis is challenging due to the occult nature of CD-associated SBA, and imaging and endoscopy alone make it difficult to detect the pathology. Treatment involves a high index of suspicion for the diagnosis and a balance between extended mesenteric resection and CD surgery's primary idea of bowel length preservation. Despite recent advances in oncology, the survival rate in CD-SBA patients remains low. Long-standing CD patients should have the terminal ileum monitored regularly and surgeons should be aware for occult SBA. Post-resection patient surveillance involves regular abdominal exams, serial surveillance, cross-sectional imaging, and monitoring for obstructive symptom recurrence. There is a lack of clear guidelines for primary prevention and surveillance of SBA, with a focus on inflammation management. Preoperative diagnosis techniques are scarce, and patients risk suboptimal treatment if incidental cancer is found. Strategies include right mesenteric-based surgical techniques and/or frozen section exam, always balancing cancer treatment and bowel preservation which is of high relevance in this subgroup of patients.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"28 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Margarida Dupont, G. Guidi, N. Tenreiro, Rita A. Marques, João A. Pinto-de-Sousa
{"title":"Never too late: Lynch syndrome diagnosed at the age of 71","authors":"Margarida Dupont, G. Guidi, N. Tenreiro, Rita A. Marques, João A. Pinto-de-Sousa","doi":"10.18203/2349-2902.isj20240580","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240580","url":null,"abstract":"Lynch syndrome is an autosomal dominantly inherited disease characterized by a mutation in one of the deoxyribonucleic acid mismatch repair genes. In consequence of this defect, patients have higher risk of developing early colorectal and endometrial cancer (among others types of cancer). This syndrome accounts for 3% of all colorectal cancers and 10% to 19% of colorectal cancers diagnosed before the age of 50. Total abdominal colectomy is the best treatment for patients with Lynch syndrome who develop colorectal cancer.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140411908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enterobius vermicularis infection at time of appendicectomy: is it a neglected risk factor?","authors":"Bethany K. Matthews, Michael Auld","doi":"10.18203/2349-2902.isj20240598","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240598","url":null,"abstract":"Obstruction of the appendiceal orifice is well established as a potential cause of appendicitis. However, it remains debated as to if appendiceal orifice obstruction secondary to Enterobius vermicularis is considered a risk factor for appendicitis or appendiceal colic. Enterobius vermicularis maintains an increased prevalence within lower socioeconomic and human development index regions. Whilst Australia has an overall high human development index it has significant variability in health literacy and socioeconomics. The purpose of this literature review is to evaluate the relationship between Enterobius vermicularis and appendicitis, to review the prevalence of Enterobius vermicularis appendicectomies in lower human development index and socioeconomic status communities, and to review the Australian based Enterobius vermicularis literature available. A comprehensive review of the literature was performed to review the prevalence of Enterobius vermicularis at time of appendicectomy. PubMed, Scopus, and Google Scholar databases were investigated for applicable studies published until December 2023. Enterobius vermicularis within the appendiceal lumen may cause irritation and lymphoid hyperplasia resulting in appendiceal colic with a similar clinical presentation to that of acute appendicitis. An increased association between Enterobius vermicularis, low human development index, and socioeconomic status is suggested. Public health interventions reduce Enterobius prevalence. A single Australian based study from 1994 was identified. Enterobius vermicularis infection is a neglected risk factor for appendiceal colic. A high index of suspicion for Enterobius vermicularis infection should be taken for clinically stable patients with normal inflammatory biochemistry and low human development index. Further research is required to assess if there is a disparity in Enterobius vermicularis in relation to human development index, socioeconomic status, and remoteness within Australian communities.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"40 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140414276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sandeep Verma, Vidit, Gaurav Kataria, Rituparna Chatterjee, B. Arora
{"title":"Complex management of larger strangulated incisional hernia in a post-multiple abdominal surgery in a morbidly obese patient-a case report and surgical review","authors":"Sandeep Verma, Vidit, Gaurav Kataria, Rituparna Chatterjee, B. Arora","doi":"10.18203/2349-2902.isj20240591","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240591","url":null,"abstract":"Strangulated incisional hernia following a post-hernia repair is a serious and potentially rare life challenging condition that can occur after surgical intervention. Incisional hernias accounts for 15-20% of all abdominal hernias which occur at the site of a previous surgical incision where the integrity of the fascia has not been fully restored. We are presenting a case report of a 49 years lady who came with complaints of abdominal swelling and pain abdomen following multiple abdominal surgeries diagnosed with strangulated incisional hernia following post hernia repair. It was managed by emergency surgical intervention that is removal of previously kept mesh and resection of gangrenous segment of bowel with end ileostomy after keeping overall patient’s condition.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Humeral shaft fractures in adults: management and evaluation of treatment in 50 cases","authors":"A. Camara, N. M. Camara, M. M. Diallo, L. Lamah","doi":"10.18203/2349-2902.isj20240567","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240567","url":null,"abstract":"Background: The management of humeral shaft fractures is a real challenge in our regions.\u0000Methods: This was a prospective, descriptive single-center study involving 50 patients meeting our inclusion criteriaof colorectal carcinoma analysing incidence, clinicopathological features and outcome after different therapies including surgery, radiotherapy and chemotherapy.\u0000Results: We enrolled 50 patients, 43 men (86%) and 7 women (14%), with a sex ratio of 3.07. Mean age was 32.3 years, with extremes of 18 and 79 years. The left side was affected in 46 cases (92%). Lesions were predominantly located in the middle 1/3 in 39 cases (78%). Treatment was orthopedic in 30 patients (60%). Surgical treatment was performed in 20 patients (40%), with screw-plate predominating in 14 cases (28%), followed by hackethal pinning in 5 cases (10%) and combined treatment in one case (2%). At six months' follow-up, our results were very good and good in 36 cases (72%) according to the modified Stewart and Hundley functional score.\u0000Conclusions: Humeral shaft fractures are rare fractures for which orthopedic treatment is still indicated. Complications include radial nerve paralysis and pseudarthrosis.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Facklamia hominis isolated from infected sebaceous cyst on the breast","authors":"Tushar L. Agrawal, Jennifer W. Chang","doi":"10.18203/2349-2902.isj20240584","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240584","url":null,"abstract":"Facklamia hominis is a gram-positive, catalase-negative, facultatively anaerobic coccus that is a rare human pathogen, with fewer than 15 cases isolated in the literature. We present the case of a 62-year-old female with an infected left breast sebaceous cyst treated successfully with surgical excision and flucloxacillin. Subsequent culture and microscopy isolated the organism Facklamia hominis. To the best of our knowledge, this is the first reported case of Facklamia hominis isolated from the breast, and the first reported isolate of the organism from a clinical specimen in Australia.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140411741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}