Original Research Article
Aug. 7, 2022
Management and Outcome of 50 Traumatic Gut Injury Cases
Dr. Mohammad Fazlul Haque, Dr. Mohammad Raisul Islam, Dr. Atikul Ahsan
SAS J Surg | 523-529
DOI : 10.36347/sasjs.2022.v08i08.006
Introduction: Traumatic gastrointestinal tract perforation is one of the commonest abdominal emergencies. The number of admitted trauma patients just focuses the tip of the iceberg because a lion's share of these ill-fated people with abdominal trauma pass their last breathe on the way to the hospital. So what should we do to counter this epidemic and what necessary steps should be taken to reduce the mortality and improve the morbidity was our aim of the study. Although this small study cannot draw a valid conclusion in comparison to the large series of western situations. This study was designed to present the experience of 50 patients with traumatic gastrointestinal tract perforation who were admitted to the surgery department, at Dhaka Medical College Hospital from July 2007 to December 2007. Cases were selected randomly. Standard protocol was followed for analysis and studying of the factor modifying morbidity and mortality. Aim of the study: The aim of the study was to observe the management and outcome of 50 gut injury cases in a tertiary-level hospital in Dhaka, Bangladesh. Methods: This cross-sectional observational study was conducted at the Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh. The study duration was 1 year, from January 2007 to December 2007. A total of 50 cases were selected for the purpose of this study from those admitted to the study hospital due to traumatic gut injury. Result: The majority of the patients was male and was of the young group. Penetrating groups (60%) predominate over the blunt group (40%). Penetrating injuries were mainly caused by stab and gunshot injuries on the other hand road traffic accidents were mainly responsible for blunt trauma. 58% of patients were in shock on admission and 48% had associated extra-abdominal injury. 52% of patients were resuscitated successfully by means of blood and I/V fluid and most of them were resuscitated within 1-4 hours. The diagnosis was mainly based on .......
Original Research Article
Aug. 5, 2022
Orbital Exenteration: Indications and Reconstruction Methods
Dehhaze Adil, Echmili Mouad, Tazi Hanae, Tita Sara, Taybi Otmane, Diher Issam, Daghouri Nada-Imane, Laabaci Rim
SAS J Surg | 516-522
DOI : 10.36347/sasjs.2022.v08i08.005
Orbital exenteration is a disfiguring surgery; its major indication is the treatment of extensive orbito-palpebral malignancies. The reconstruction of the residual cavity is a real challenge despite the different reconstruction techniques, especially on weakened terrain. The purpose of this study was to assess and compare the clinical indications and reconstructive methods and outcomes with previously reported data. A retrospective study was conducted on five patients who underwent orbital exenteration surgery. Those cases were collected in the department of plastic, reconstructive and burns surgery at the Al kortobi Hospital in tangier (Morocco) between mars 2021 and June 2022. The main outcome measures were demographics surgery type, clear margins histologically, surgical complications and local recurrence. Five patients were included in this study, 3 men and 2 women with an average age of 75 years old (60 to 90 years old), mean follow up was 5 months. All patients presented with a tumor in the eyelid or periocular skin, diagnosis included basal cell carcinoma in three patients and squamous cell carcinoma in the other two. Total orbital exenteration was performed in all patients, the cavity was filled with a temporalis muscle flap in four cases and with a local flap (type LLL= dufourmental flap) in one case. Clear margins tumor was obtained in all cases and no complications or recurrence were seen so far. Adjuvant radiation therapy was conducted on three cases. Reflecting the literature on the subject, exenteration aims at local control of disease invading the orbit that is potentially fatal or relentlessly progressive. We have promoted reconstruction using the temporal muscle flap thanks to its advantages such as a single operative step thus reducing operative morbidity, good skin coverage, fast healing and fewer postoperative complications. In term of our study, orbital exenteration retains its place in orbito-palpebral cancer surgery, while the temporal .......
Original Research Article
Aug. 4, 2022
Current Trends of Conservative Management of Blunt Abdominal Solid Organ Injury
Faroque, M. O, Tuli, F. A, Bhuiyan, M. J. K, Talukdar, T, Sarwar, S. M, Hossain, M. A, Hossain, M. S, Karmakar, P. K
SAS J Surg | 508-515
DOI : 10.36347/sasjs.2022.v08i08.004
Introduction: Bangladesh is one of the most densely inhabited countries in the world. Road traffic accidents are one of the leading causes of morbidity, and the incidence of blunt abdominal injuries is on the rise. Over the last several years, the treatment of blunt abdominal injury (BAI) has changed dramatically. Conservative or non-operative treatment (NOM) of liver, spleen, and kidney injuries has proven to be quite effective. Methods of study: A prospective observational study was done in Dhaka medical college with 50 consecutive patients included from January 2010 to June 2010. Results: Within the 50 consecutive patients 88% were male, and 64% were motor vehicular crashes. 26 patients (52%) had a liver injury; 5 (10%) had a renal injury; 7 (14%) had a splenic injury and 3 (6%) had a pancreatic injury; 9(18%), 2 patients (4%) had both liver and spleen injury, 3 patients (6%) had both spleen and kidney injury. 39 (78%) patients were managed successfully by a conservative approach. Compared with these patients who underwent non-operative management (NOM) initially, patients in the operative group had a higher injury severity score. (p < 0.001). Twenty-seven patients (high risk) were successfully treated without surgery. No serious complication was found on routine image follow-up. Conclusion: Conservative or non-operative management of blunt abdominal solid organ injury in hemodynamically stable patients is highly successful in many fields when compared with the operative group, including the outcomes of morbidity, mortality, and length of hospital stay.