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  • ISSN: 2379-0911
    Current Issue
    Volume 6, Issue 2
    Case Report
    Kunal Choudhary, Muzzafar Zaman*, Gurinder Kaur, Aliya Shah, Rahul Yadav, and Ashish Choudhary
    Acquired abdominal intercostal hernia (AAIH) is protrusion of abdominal viscera through an intercostal space under an intact diaphragm and is a very rare condition. In most cases the disease is acquired post trauma or surgery. The main presentation being swelling over the chest with or without pain. Complications like incarceration or strangulation may occur if left untreated. Computer tomography remains the gold standard investigation and AAIH should be always suspected when chest swelling occurs after a trauma or surgery. Surgery remains the only modality of treatment with tension free mesh repair being the preferred method either done via open or laparoscopic technique. We present one such rare case report of acquired abdominal intercostal hernia through the defect between 10th and 11th rib over the left upper abdomen over a previous surgical scar.
    Vasileios Mougios, Lhagva Sanchin*, and HJ Meisel
    Pneumocephalus describes the presence of air inside the cranial cavity. It can be asymptomatic or have insidious progression resulting in tension pneumocephalus. The latter requires an aggressive treatment as it can lead to neurological damage and death. The cause as well as the mechanisms of pneumocephalus varies. The treatment options are conservative for the asymptomatic patients and surgical for the more aggressive tension pneumocephalus. In our case we present a patient who after a craniofacial injury and surgery developed delayed pneumocephalus in the form of an air-cyst.
    Research Article
    Kunal Chowdhary, Muzzafar Zaman*, Gurinder Kaur, Aliya Shah, Rahul Yadav and Ashih Chowdhary
    Introduction: Biliary calculus disease is commonest disorder affecting the gastrointestinal tract. There is good evidence in the literature to support wound infection post cholecystectomy due to presence of bacteria in bile with reported incidence ranging from 4-10 % in various studies. Some surgeons use the outcome of bile cultures to guide their choice of empirical therapeutic antibiotics for subsequent wound infections. The present study evaluates the microbial spectra of bile in patients of cholelithiasis and association with postoperative wound infection in a rural setup.
    Aim: To study the incidence of microbial spectra in gallstone disease and effect of bacteriobilia on wound infection.
    Material and methods: The study included fifty patients of symptomatic gallstone disease including all age group and both the gender. All the patients underwent cholecystectomy laparoscopic or open with or without common bile duct exploration after giving single prophylactic antibiotic dose (Inj. Ceftriaxone 1gm). 2 to 3ml bile was taken for culture either from common bile duct or from the gall bladder for microbiological analysis in a sterile labeled container. Colony morphology was read and confirmed with biochemical reaction. Patient were divided into two groups with group A included patients with positive bile culture, group B having patients with sterile bile culture report. In the postoperative period those patients with positive bile culture were given antibiotics according to culture report. Patient with wound infections were recorded and wound cultures sent and compared with bile culture report for similarities of reports. Statical analysis of the collected data done using Chi-square test.
    Results: Bile exhibited positive culture in 14 (28%) case with Escherichia coli 7(14%) as the most common organism encountered followed by Klebsella 2(4%), Citrobacter 2(4%), Dipheroids 1(2%), Enterococcus Facaelis 1(2%), Candida 1(2%). Anaerobic organism growth was not seen in any of the bile culture.
    Conclusion: Bile spillage during intraoperative period of bile containing bacteria predisposes to post operative wound infection. Prophylactic antibiotic should be administered to all the cases undergoing cholecystectomy.
    Short Communication
    Susanna Lam*, Ngee -Soon Lau, Jerome Martin Laurence, and Deborah Jean Verran
    Surgical site infections in renal transplant recipients can be managed with negative pressure wound therapy (NPWT), however complications associated with the NPWT are uncommon. We describe a case series in which the presence of new, and or, persistent infections in the presence of NPWT has complicated the management of renal transplant recipients in our unit. This has required further surgical or radiological procedures, additional antimicrobial therapy and resulted in prolonged wound healing of up to 200 days. Vigilance, prompt management and recognition of the potential for infections associated with NPWT is required in the management of complex renal transplant recipients.
    News Letter
    Susanna Lam* and Deborah Jean Verran
    Abdominal wall complications occur in 3-18.6% ofrenal transplant recipientspost operatively [1-5], with the spectrum including surgical site infections (SSI), acute superficial or deep fascial wound dehiscence, slow wound healing andsubsequent hernia formation.
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