Vrinda, S Raj (2012) A Prospective study on Emergency Bowel Resection and Anastomosis. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
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Abstract
This dissertation “A Prospective study on Emergency Bowel Resection and Anastomosis” is done during the period of 2009-2011 at Government Mohan Kumaramangalam Medical College and Hospital, Salem under the guidance of Prof. Dr. R. Kattabomman. M.S, H.O.D of General surgery. The aim of the study is to identify various etiologies that resulted in emergency resection of bowel, to discuss various clinical presentation, outcome of surgery and postoperative complications including mortality. Inclusion criteria: All cases undergoing emergency bowel resection and anastomosis. Exclusion criteria: Patients undergoing elective bowel resection and anastomosis are excluded. Patients with associated head injury or chest injury in case of abdominal trauma who are undergoing bowel resection and anastomosis are also excluded. After the study from 2009 to 2011 based on the above criteria the findings are as follows. A total number of 40 cases came under the study. Commonest age group who underwent bowel resection and anastomosis was between 51-60 years. There was a male preponderance. Commonest presentation which resulted in emergency resection and anastomosis of bowel was obstructed hernias majority being incisional hernias. Other presentations were intestinal obstruction due to adhesion band, abdominal trauma, mesenteric ischemia, intussusception, colonic growth, ileal stricture, ileal perforation, ileocaecal knotting, diverticulosis causing intestinal obstruction. Most common part of bowel which underwent resection was ileum, followed by jejunum, colon, ileum-caecum. Most common type of anastomosis was ileo-ileal followed by ilecolic, jejuno-jejunal and Jejunocolic. Majority of cases had an end to end anastomosis. All except one case underwent double layer closure of bowel. Ileotransverse anastomosis was the most common small bowel to large bowel anastomosis. Majority of patients had an uneventful recovery. Major post operative complications included wound dehiscence-relaparotomy and enterocutaneouc fistula. Mortality was due to cardiorespiratory arrest and sepsis. In this study laparotomy was noticed as a major risk factor. It leads to intra abdominal adhesions resulting in bowel obstruction and gangrene and also incisional hernias leading to obstruction and gangrene. In suspected mesenteric ischemias an ileostomy is the preferred choice than an anastomosis. Emergency bowel anastomosis involving large bowel always bears a risk for anastamotic breakdown and sepsis. Bowel anastomosis is not preferred in patients with poor general condition. An ileostomy/colostomy is a better option.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Emergency, bowel, resection, anastomosis. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 14 Sep 2020 17:56 |
| Last Modified: | 15 Sep 2020 16:01 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13145 |
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