Non Traumatic Abdominal Surgical Emergencies

Sutha, S K S and Sellamoni, S (2007) Non Traumatic Abdominal Surgical Emergencies. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: An acute abdomen is best defined as a short-term occurrence of abdominal symptoms that suggest disease, which definitely or possibly threatens life, and may or may not demand immediate operative interference. The majority of emergency admissions to surgical wards are patients complaining of acute abdominal pain. Acute abdominal pain continues to provide a large work load for the general surgeon and also many diagnostic and management problems. Different techniques have been introduced over the past to help in the management of acute abdomen. An accurate diagnosis is essential for the correct treatment, which in many cases will prevent the death of the patient. The natural history of acute abdomen depends on the pathological process involved, which is some instances may resolve spontaneously with or without treatment and at other time may progress to generalised peritonitis and death. Hasty decisions are rarely necessary and if carried out may be incorrect or misleading. The history and physical examination done by an unhurried surgeon remains the cornerstones of the diagnosis, which is confirmed by laboratory data and or when necessary, by radiographic studies. If this information is unnecessary, the periodic reexamination helps document the progression of the disease and often avoids unnecessary surgical intervention. Understanding the anatomy and physiology of the peritoneal cavity as well as the pathological process that occur is essential for an accurate diagnosis and treatment. Today the combination of improved diagnostic procedures, antibiotics and better anaesthesia and preoperative and post operative patient care has led to a decrease in morbidity and mortality of patients with acute abdomen. AIM OF THE STUDY: 1. To determine the common causes of acute abdomen and their incidence in our hospital. 2. To study the age and sex distribution of these condition. 3. To findout the various types of the above causes of non traumatic abdominal emergencies and discuss their incidence, age and sex distribution of each. MATERIALS AND METHODS: Patient Selection criteria: 1. All the patients presenting as acute abdomen who are taken up for surgery during the period from June 2004 to May 2005 at Kilpauk Medical College and Hospital were included in my study. All patients with trauma induced abdominal injuries were excluded from the study. 2. Patients treated by conservative management were excluded from this study. METHODOLOGY: A total of 390 patients were studied during this period. On admission a detailed history was taken and a thorough physical examination was done. Necessary emergency investigations were done for all the patient. A methodical diagnosis was arrived at and treated accordingly. CONCLUSION: 1. Our study shows that appendicectomy still remains the commonest non traumatic abdominal emergency. 2. The age incidence of appendicitis in my study show a definite shift to patients between 15 and 30 yrs. accounting for almost 77% of all cases. 3. There was a definite male preponderance of cases studied. 4. Duodenal perforation was the commonest hollow viscus perforation. 5. Our study showed a decrease in the average age of peptic ulcer perforation with an overwhelming majority of male patients. 6. Ileal perforation was the next commonest cause of perforations almost all being due to typhoid. 7. Inguinal hernias were the commonest herniae to become obstructed. The age and sex incidence conferred to the previous studies. 8. Small bowel obstruction seems to be disease of the young as shown by our series. There was almost equal incidence among both sexes. 9. Adhesions were the first commonest cause of intestinal obstruction, only after obstructed inguinal hernias. 10. Large bowel obstruction with an average age incidence of 50 yrs. and a male predominance seems to be a disease of the middle aged. Volvulus and malignancies accounted for all the cases. This conforms to the general view.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Non Traumatic Abdominal ; Surgical Emergencies.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 05 Jun 2018 17:39
Last Modified: 06 Jun 2018 02:52

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