Analysis of acute abdomen

Balaji Sharma, G R (2014) Analysis of acute abdomen. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

BACKGROUND: The study was conducted in Tirunelveli medical college hospital from January 2013 to November 2013. Total of 250 consecutively operated cases of various etiologies have been studied. Patient clinical presentation, accurate history, operative findings and post operative complications were noted. AIM & OBJECTIVES: 1. To analyse the proportion of various causes. 2. To analyse the sex and age wise distribution. 3. To analyse the commonest symptoms and signs. 4. To analyse the accuracy of clinical diagnosis. 5. To analyse the various surgical management. 6. To analyse the surgical outcome. MATERIALS AND METHODS; The study material comprises the detailed clinical study of 250 consecutively operated cases of acute abdomen of different etiology. The materials for the clinical studies were collected from the cases admitted in the emergency department of Tirunelveli Medical College Hospital, Tirunelveli, in the period between January 2013 to November 2013. For all the cases admitted with non traumatic abdominal pain are included in the study. The accurate history taken and detailed clinical examinations done. The following minimal investigations done in selected patients, 1. Complete blood count. 2. Urine routeine. 3. Blood sugar, urea, creatinine& electrolytes. 4. Blood grouping and typing. 5. Liver function test. 6. Bleeding time and clotting time. 7. X- ray chest, X – ray abdomen erect. 8. Ultrasonogram. After an adequate preoperative preparation patients subjected for laparatomy. The operative findings and operative managements are noted at laparatomy. Patient followed for immediate postop and for atleast 4 months to note the compications and success of treatment. INCLUSION CRITERIA: All the non traumatic abdominal pain patients who underwent surgical treatment included in this study. 1. Acute appendicitis. 2. Perforation peritonitis of various etiologies. 3. Intestinal obstruction of various etiologies. EXCLUSION CRITERIA: 1. Traumatic causes of acute abdomen. 2. Medical causes of acute abdomen. 3. Paediatric causes. 4. Obstretic and Gynaecological causes. 5. Urological causes. 6. Acute abdomen managed conservatively. RESULTS: In our study of acute abdomen, the presentation of acute appendicitis was 46.4%, perforation peritonitis was 30.8%, Intestinal obstruction was 22.8%. Male to Female ratio was 2.2:1 with the male predominance. The clinical presentations were vomiting 58%, constipation 40%, distension 26%, fever 25.6%. The clinical signs were tachycardia 74.4%, guarding 68.8%. The clinical accuracy was 91%. The emergency surgeries done were appendicectomy 46.4%, perforation closure with live omental patch 26%. The post operative complications noted were wound infection 22%, respiratory infection 11.6%, mortality 4.8%. CONCLUSION: The commonest acute abdominal emergency was acute appendicitis, second commonest was perforation peritonitis, third commonest was intestinal obstruction. Acute abdomen commonly seen in males. Commonest age group affected was 41 to 50 years. The commonest presentation next to abdominal pain was vomiting. The commonest clinical sign next to abdominal tenderness is tachycardia. The commonest surgery performed was emergency open appendicectomy. Commonest post operative complication was wound infection. Mortality most commonly seen in cases of perforation peritonitis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Acute abdomen ; operated ; complications.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 24 Jun 2018 18:29
Last Modified: 24 Jun 2018 18:29
URI: http://repository-tnmgrmu.ac.in/id/eprint/8615

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