Online ISSN: 2515-8260

Keywords : Laparotomy


A Study to Observe the Cases of Abdominal Wound Dehiscence in Patients Undergoing Emergency Laparotomy with Midline Incision

Dr. Amuleek Kaur, Dr. Karaninder Singh Wilku,Dr. Gopal Swaroop Bhargava,Dr. Ajaypal Singh Sandhu .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 79-86

Aim: A study to observe the cases of abdominal wound dehiscence in patients undergoing emergency laparotomy with midline incision.
Objectives: To calculate the frequency of abdominal wound dehiscence in patients undergoing emergency laparotomies subjected to midline incision and to determine hypoproteinemia, anemia and surgical site infection as contributing factors for abdominal wound dehiscence in emergency laparotomies with midline incision.
Materials and Methods: Observational cohort study carried out in the department of General Surgery at Sri Guru Ram Das University of Health Sciences, Vallah, Sri Amritsar on 60 patients who underwent emergency laparotomy with midline incision.
Results: In our study, patients belonging to various kinds of age group and socio economic background were included in the study irrespective of the gender. Amongst the 60 patients included, abdominal wound dehiscence was seen in 36 patients corresponding to 60% of the sample size. This study was endeavoured to delineate the role of anemia, hypoalbuminaemia and SSI (surgical site infection) in the dehiscence seen in these patients and it was observed that majority of the patients undergoing abdominal wound dehiscence had hypoalbuminaemia thus, making it the most significant risk factor followed by anemia and surgical site infection.
Conclusion: In this study we concluded that Abdominal wound dehiscence is a serious sequel of impaired wound healing. Many factors can predispose to this grave complication of which anemia, hypoproteinaemia and surgical site infection carry enormous significance. Patients with these risk factors require more attention and special care to minimize the risk of occurrence. Postoperative abdominal wound dehiscence can be prevented by improving the nutritional status of the patient, strict aseptic precautions, optimization of patient's hemodynamic losses and by proper surgical technique. Early diagnosis of burst abdomen and aggressive treatment helps in reducing morbidity and mortality. Some of the major factors like the ones mentioned in this study must be vigilantly looked for and treated to prevent this catastrophic complication.

COMPARISON BETWEEN TAP BLOCK AND LOCAL INFILTRATION FOR POST-OPERATIVE ANALGESIA IN PATIENTS UNDERGOING LAPAROTOMY

Dr. Aela Sifat Hinna, Dr. Abdul Hakim, Dr. Tantray Tariq Gani , Dr. Rukhsana Najeeb, Dr. Khalid Mudasir Munshi

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3173-3185

Nociceptive pain is often regarded as the key feature of acute post- operative pain. Laparotomy is a major surgical procedure which is associated with substantial post operative discomfort and moderate to severe pain postoperatively. Aims: This prospective observational study was undertaken to compare the analgesic effect of TAP block and Local infiltration of incision site in patients undergoing laparotomy. Materials and Methods: 100 patients of ASAI and ASAII undergoing laparotomy were enrolled for the study to receive either TAP block with 40ml of 0.2% Ropivacaine (20ml on each side) or local infiltration with 40ml of 0.2%  Ropivacaine around the wound. Patient’s VAS score, requirement for rescue analgesia, hemodynamic parameters and any side effects were noted for 48 hours. Results: Patients receiving TAP block had significantly lower VAS scores and requirement for rescue analgesia. However the hemodynamic parameters and side effects were comparable between the 2 groups. Conclusion: TAP block is significantly better for analgesia in patients undergoing laparotomy compared to local infiltration in the setting of a multimodal analgesic regimen without increasing the side effects.

Prospective observational assessment of the aetiopathological profile of on small bowel perforation and its management

Dr. Alishala Lingam, Dr. Talluri Suresh Babu, Dr. Talla Srinivas

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3583-3589

The objective of the study was to study the various causes, incidences and clinical features of small bowel perforations and various surgical procedures and it’s the outcome.
Methods: The present study was conducted in the Department of General Surgery for the period of 2 years and all the patients of small bowel perforation of both sexes and of different ages was included. 50 patients were included in the study. The protocol was reviewed and approved by the ethics committees of this institution. Patients were included after taking their informed consent for the study.
Results: In the present study, majority of the patients (36%) were of age group 36-45 followed by (28%) 26-36 age groups. There were 40 (80%) males as compared to females 10 (20%). In this study, 35 cases (70%) of perforation were due to peptic ulcers. Next order cases due to trauma consist of 10 cases (20%). Tubercular perforation was seen in 2 patients (4%), and due to Crohn’s disease, only 1 case was found. Typhoid perforation was seen in 1 case. Malignant perforation was in 1 case (2%) which was found to be gastrointestinal stromal tumours after histopathological examination. In this study, free peritoneal fluid was found in 43 cases (86%). Free gas in the peritoneal cavity was found in 40 cases (80%) due to third space fluid collection and escape of bowel gas into the peritoneum, respectively. Mesenteric lymphadenitis and thickened omentum were found in 2 cases (4%) due to tuberculosis and malignancy.
Conclusion: Duodenal perforation is the most common cause of small intestinal peforation. Smoking and consumption of alcohol & NSAIDS are the most important risk factors for small bowel perforation. Patients mainly presented with abdominal pain and distension with features of peritonitis. X-ray abdomen suggested of pneumoperitoneum in most of the patients. Resuscitation followed by closure of perforation with omental patch was the most common management procedure done.

ANALYSING THE POTENCY AND ROLE OF DIAGNOSTIC LAPAROSCOPY IN SUBJECTS WITH CHRONIC ABDOMINAL PAIN.

Dr. SK. Khairul Enam,Dr.Shruti Yadu,Dr. Deepak Kumar Benia, Dr. Vaishali Bhagat

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1006-1011

Background: Most demanding and challenging conditions to manage across the globe in
subjects of all ages are chronic idiopathic pain syndromes. Various diagnostic advancements
have been made, pain in these subjects still presents a challenge for all available diagnostic
and management methods.
Objectives: The present study was conducted to assess the efficacy and role of diagnostic
laparoscopy in the identification of the etiology of chronic abdominal pain which is not
diagnosed.
Materials and methods: In 30 subjects with chronic abdominal painwith unknown etiology
or who were refractory to the treatment for more than 3 months. Diagnostic laparoscopy was
done for all the subjects. The collected data were subjected to statistical evaluation and the
results were formulated.

ANALYSING THE POTENCY AND ROLE OF DIAGNOSTIC LAPAROSCOPY IN SUBJECTS WITH CHRONIC ABDOMINAL PAIN..

Dr. SK. Khairul Enam, Dr. Shruti Yadu, Dr. Deepak Kumar Benia, Dr. Vaishali Bhagat

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1852-1857

Background: Most demanding and challenging conditions to manage across the globe in
subjects of all ages are chronic idiopathic pain syndromes. Various diagnostic advancements
have been made, pain in these subjects still presents a challenge for all available diagnostic
and management methods.
Objectives: The present study was conducted to assess the efficacy and role of diagnostic
laparoscopy in the identification of the etiology of chronic abdominal pain which is not
diagnosed.
Materials and methods: In 30 subjects with chronic abdominal painwith unknown etiology
or who were refractory to the treatment for more than 3 months. Diagnostic laparoscopy was
done for all the subjects. The collected data were subjected to statistical evaluation and the
results were formulated.

Effect of Various Co-Morbidities on Abdominal Wound Dehiscence after Midline Laparotomy

Venkatesham B

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 960-967

Background: Wound dehiscence is defined as separation of all layers of incision. It may
be partial or complete. Partial when one or more layers have separated but either the
skin or the peritoneum is intact. Complete when all layers of the abdominal wall have
opened apart and this may or may not be associated with evisceration of viscus. The
study aimed to find out and record the etiological factors for Burst abdomen.
Materials and Methods: This study was prospective, randomized and comparative
study conducted on 120 patients undergoing midline laparotomy in the Department of
General Surgery, Kalinga Institute of Medical Sciences over a period of 1 year. Patients
were selected who require midline laparotomy either as emergency or elective
procedure. 120 patients who were divided into two groups 60 each by sealed envelope
method and they were randomized into Group 1 and Group 2. The patients in Group 1
underwent closure of rectus sheath with conventional continuous closure technique and
in Group 2 underwent closure with interrupted X suture technique. A total of 60
patients were included in each group.
Results: In this study, there were 44% males and 15% females in Group -1 while there
were 49% males and 12% females in Group 2. In group 1, mean age was 48.03 years
and SD ± 16.15. In group 2, mean age was 46.44 years and SD ± 15.68 In Group 1, out of
60 patients wound dehiscence occurred in 22 cases while in Group 2, out of 60 patients
wound dehiscence occurred in 9 cases. In Group 1, 17 patients were anemic, 5 patients
were diabetics, 18 patients had uremia, 44 patients had hypoalbuminemia and 49
patients had chest infection. In Group 2, 11 patients were anemic, 7 patients were
diabetics, 17 patients had uremia, 41 patients had hypo‌albuminemia and 34 patients
had chest infection.

ANALYSING THE POTENCY AND ROLE OF DIAGNOSTIC LAPAROSCOPY IN SUBJECTS WITH CHRONIC ABDOMINAL PAIN

Dr. SK. Khairul Enam, Dr. Shruti Yadu, Dr. Deepak Kumar Benia, Dr. Vaishali Bhag

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 993-998

Background: Most demanding and challenging conditions to manage across the globe in
subjects of all ages are chronic idiopathic pain syndromes. Various diagnostic advancements
have been made, pain in these subjects still presents a challenge for all available diagnostic
and management methods.
Objectives: The present study was conducted to assess the efficacy and role of diagnostic
laparoscopy in the identification of the etiology of chronic abdominal pain which is not
diagnosed.
Materials and methods: In 30 subjects with chronic abdominal painwith unknown etiology
or who were refractory to the treatment for more than 3 months. Diagnostic laparoscopy was
done for all the subjects. The collected data were subjected to statistical evaluation and the
results were formulated.

DIAGNOSIS AND TREATMENT OF ADHESIVE SMALL BOWEL OBSTRUCTION WITH USING LAPAROSCOPIC METHOD

Iskandar Shonazarov; Sardor Murodullaev; Sunnatillokhon Kamoliddinov; Adkham Akhmedov; Davlatshokh Djalolov

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 3192-3198

Adhesive disease of the abdominal cavity, complicated by acute intestinal obstruction, is one of the most difficult diseases of the abdominal cavity in terms of treatment and diagnosis. The urgency of the problem is determined by the complexity of prevention and treatment of the studied complication, the widespread increase in surgical activity, the expansion of indications for performing operations of extended volume and combined interventions for diseases of the abdominal cavity and retroperitoneal space. Analysis of the literature shows that acute intestinal obstruction occupies one of the first places among urgent pathology of the abdominal cavity in terms of the frequency of complications and fatal outcomes. An increase in the number of patients, the severity and recurrent nature of the disease, difficulties in diagnosis, unsatisfactory immediate and long-term results of treatment of patients with adhesive small bowel obstruction, as well as a high percentage of disability determines the relevance of the chosen topic.