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  • ISSN: 2379-0911
    Volume 6, Issue 1
    Clinical Image
    Luigi Conti*, Davide Pertile, Filippo Banchini, Antonio Banchini, Franco Voltolini, and Patrizio Capelli
    Retained surgical items (RSI) are still an open issue with relevant medico-legal implications; the mere occurrence of these events is expression either of an objective omission by medical staff and carelessness of safety protocols, adducing to the involved health professionals a civil, administrative and penal accountability.
    Research Article
    Vikal Chandra Shakya*, Anir Ram Moh Shrestha, Anang Pangeni, Bikram Byanjankar, Rabin Pandit, Anuj Jung Rayamajhi, Prajwal Bhattarai, Rupesh Yadav, Subhash Paudel, Lokesh Raj Sharma, and Rabin Koirala
    Spectrum of perforation peritonitis in the Nepalese setting hasn’t been well documented. This study helps us to understand the different spectrum of this entity as we encounter them in our set-up. This study is a prospective descriptive study in patients presenting with a diagnosis of perforation peritonitis who underwent operative intervention from January 2010 to December 2016 at tertiary centers in central Nepal. A total of 500 patients were included in the study. The mean age of presentation was 37.02 + 19.87 years (range 2-94 years). The most common cause was, duodenal perforation, 201 cases (40.2%); followed by appendicular, 185 patients (37%). The morbidity rate was 37.2%. The mortality rate was 8.2%. 1.8% patients left against our medical advice. The scenario of perforation peritonitis is different in our setting, the most common cause being due to acid-peptic disease, then appendicular perforation and small bowel perforations. The morbidity rate and mortality rate is comparable to other series.
    Ramanuj Mukherjee, Shreya Sengupta*, and Sayantan Bose
    Port site infections have emerged to become an important post laparoscopic morbidity. Several studies have been conducted till now related to port site infections and revealed that the most common bacteria isolated from those port-site infection were Non-tuberculous mycobacterium. However the treatment protocol, including the drug regimen and duration of therapy varied from clinician to clinician and from hospital to hospital. Hence this meta-analysis, to review the results of contemporary literature. Source of the organism was water used for washing instruments and an important factor of ineffectiveness of 2% glutaraldehyde with a short contact period against non-tuberculous mycobacteria.
    Review Article
    Santoni R, Banchini F, Grassi C, Conti L*, Capelli P
    Gastrointestinal stromal tumor (GIST) is the term for a specific, immunohistochemically KIT-positive (90% of KIT mutations involve exon 11) mesenchymal neoplasm of the gastrointestinal tract and abdomen.
    Neoadjuvant therapy can be effectively used for the treatment of metastatic and recurrent GIST or when the surgery can’t be radical at the first time.
    Symptoms of GIST are gastrointestinal bleeding, gastric pain, intestinal obstruction, hemoperitoneum because of tumor rupture. Most of GISTs are detected incidentally (CT scan, endoscopy for other reasons) and they are less than 5 cm in size.
    As is known, surgical resection is always the first therapeutic option if R 0 can be achieved. Post-therapy surgery with Gleevec® (Novartis) is the choice in metastatic, recurrent GIST and in situations where due to the site or size, surgery may not prove radical or may jeopardise the patient’s quality of life. Borderline cases should be discussed collectively in key centres with a radiologist, oncologist and surgeon.
    Case Report
    Kunal Chowdhary, Muzzafar Zaman*, Gurinder Kaur, Aliya Shah, Rahul Yadav, and Ashish Chowdhary
    Appendicitis has rarely been reported following solid organ transplantation. Only a few cases of appendicitis have been reported in literature after renal transplantation. The clinical condition is particularly difficult to diagnose because of the atypical presentation in such patients. Early contrast enhanced computer tomography of the abdomen helps in preventing delays in diagnosis and treatment. Nowadays, Laparoscopic appendicectomy is the treatment of choice in these patients.
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