CT findings of an abdominal cocoon.
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Diagnosis, Differential↗
Biomedical subjects
R G Shirahatti
Publications and source records attributed to R G Shirahatti.
Palliative surgery in malignant obstructive jaundice: prognostic indicators of early mortality.
A prospective analysis of 50 patients undergoing palliative bypass surgery for incurable malignant obstructive jaundice was carried out in an attempt to identify factors predicting post-operative mortality. Five clinical and nine laboratory parameters were studied. Fourteen patients died within 30 days of surgery. It was seen that levels of haemoglobin, hematocrit and serum albumin levels were significantly lower while serum bilirubin was significantly higher in patients who died compared with the survivors. Patients having Hb < 10 Gm/dL, serum bilirubin > 350 micromol/dL, serum albumin < 2.5 g/dL and prothrombin index < 60% exhibited a higher percentage of mortality. On multivariate analysis, levels of haemoglobin, serum albumin and serum bilirubin could be used to independently predict the outcome with an accuracy of 86%. This was validated by prospectively applying the regression equation derived from the first 30 patients to the next 20 patients. It was seen that the predicted outcome correlated with the actual outcome with a correlation coefficient of 0.5098 (P = 0.01). It is concluded that in patients with high bilirubin, low haemoglobin and low albumin levels palliative surgical procedures carry a high risk of post-operative mortality and non-surgical methods may be more suitable.
Adult↗
Primary malignant hemangioendothelioma of jejunum.
Primary malignant hemangioendothelioma is a rare tumor. We report a patient with a malignant jejunal hemangioendothelioma which had metastasized to the regional lymph nodes and the liver.
Hemangioendothelioma↗
Pulmonary complications of upper abdominal surgery.
Pulmonary complications encountered in 67 patients undergoing upper abdominal surgery in our unit in one year period are analysed. Pulmonary function tests and their post-operative reduction, as also the risk factors are discussed. Pathophysiology responsible for pulmonary complications is outlined.
Adolescent↗
Non-specific abdominal pain--a clinical entity.
A total of 48 cases of non-specific abdominal pain admitted in one year period were studied. Routine investigations of blood, urine, stool and X-ray examinations done after admission were negative. The pain was relieved in 48 hours time with analgesics and antispasmodics. During their follow-up in the out-patient department a variety of causes were discovered on investigations.
Abdominal Pain↗
Necrotising fasciitis (a report of 5 cases).
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Adult↗
Primary actinomycosis of the anterior abdominal wall (a case report).
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Abdominal Muscles↗
Massive rectal bleeding due to jejunal and colonic tuberculosis.
A case of massive rectal bleeding due to colonic tuberculosis in advanced pregnancy with intrauterine foetal death is reported. Patient was treated with resection of the left colon and left transverse end colostomy with closure of the rectal stump. Hysterotomy for the removal of the dead foetus was performed. The patient improved in health with antitubercular treatment. The colorectal anastomosis was performed after 4 months. Massive rectal bleeding in intestinal tuberculosis, though rare should be kept in mind.
Adult↗
Gangrenous sigmoid volvulus in a pregnant woman.
A rare case of gangrenous sigmoid volvulus in a pregnant woman causing intestinal obstruction is reported. The patient had intrauterine foetal death. Laparatomy for resection of sigmoid colon and hysterotomy for removal of dead foetus was carried out. Terminal iliac colostomy with closure of rectal stump was done in the first surgery. The patient underwent colorectal anastomosis 2 months after the first operation and recovered uneventfully.
Adult↗
Pathological rupture of malarial spleen.
Two cases of spontaneous rupture of malarial spleen are reported here. One of them was a male who was on chloroquine for an acute attack of malaria. While on therapy, he complained of pain in left hypochondrium followed by palpitations. The other patient was a female who was admitted for continuous dull aching pain and fever. In both the patients, exploratory laparotomy revealed an enlarged spleen with tear. Splenectomy was performed. Histopathological examination revealed dilated congested sinusoid with follicular atrophy, and RBCs with malarial parasites. The post-operative course was smooth in both patients.
Adult↗
Effect of pre-operative skin preparation on post-operative wound infection.
A prospective randomised trial was carried out to compare the efficacy of method of scrubbing the operative site for ten minutes with an antiseptic (GpA; n = 68) with a simplified method where the antiseptic was merely painted onto the operation site (GpB; n = 67). The median age, sex distribution and the types of procedures done in each group were similar as was the antibiotic policy. There were a total of 11 patients who got infected, 6 in the group A and 5 in the group B. No significant difference could be demonstrated in the infection rates between the two groups. It is concluded that the old method of prolonged scrubbing the operation site can safely be omitted to a more simplified version.
Anti-Infective Agents, Local↗