3 research outputs found
High velocity missile injuries of the liver
A prospective study of 15 consecutive patients admitted with high
velocity missile liver injuries of the liver was done at Lacor hospital
between November 1996 and May 1997. Operative findings, treatment
offered and factors influencing morbidity and mortality were noted. All
patients were followed up for two months postoperatively. Fourteen
patients sustained gun shot wounds while one was injured by a bomb
blast fragment. Ages ranged from 2 to 33 years (mean 24.4 years). Two
patients sustained liver injury alone while the rest had other
associated visceral injuries as well. Grade I, II and III liver
injuries were seen in 7, 5 and 2 patients respectively. One patient had
a bullet perforation of the liver and could not be classified on this
scale. Six patients received blood transfusion. Four patients (27%)
developed complications. One had a sub-hepatic abscess while the other
three had wound infections. Two patients died, one of exsanguination
and the other of septic shock. High velocity missile injuries of the
liver are associated with high transfusion needs and morbidity both of
which can be minimized by a policy of conservative surgery
Acute Bowel Obstruction in a Rural Hospital in Northern in Northern Uganda.
Background: The aim of the study is to find the aetiology and outcome
of bowel obstruction treatment in St. Mary’s Hospital Lacor
vis-Ă -vis other centres in the world. Methods: A retrospective
review of patients’ files from January 2007 to December 2008 was
done. The variables studied were age, sex, duration of symptoms, cause
of obstruction, bowel resection, length of hospital stay, postoperative
complications and mortality. Results: There were 132 patients with a
mean age of 31.5years and M:F ratio of 2.2:1. Duration of symptoms
ranged from 1 – 14days with a mean of 4days. The leading cause of
obstruction was Hernias in 53(40.2%) patients followed by Adhesions in
27(20.5%). Gut volvulus was third in 23(17.4%) patients. Bowel
resection rate was at 48.5%. Length of stay ranged from 1 – 39
days with a mean of 8 days. The commonest complication was wound sepsis
± dehiscence (50%). Morbidity rate was 24.2%. Mortality rate was
12.9% with 100% case fatality rate for neonatal intestinal atresia.
Conclusion:Obstructed/strangulated hernias rather than Adhesions are
still a leading cause of bowel obstruction
Sigmoid Volvulus and Ileosigmoid Knotting at St. Mary’s Hospital Lacor in Gulu, Uganda
Background : Sigmoid volvulus is a common cause of intestinal
obstruction in developing countries where it affects relatively young
people. Little is known about this condition in our country and there
is yet no literature from an environment like ours (northern Uganda)
where civil war has devastated the economy with most of the populace
displaced into internally displaced peoples’ camp. The main
objective of this study was to determine the demographics, treatment
and outcome of sigmoid Volvulus cases seen at Lacor Hospital. Methods
: This was both a retrospective and prospective study of patients who
presented with sigmoid volvulus at St. Mary’s Hospital Lacor over
a period of 61/2 years from 1st January 2002 to 31st July 2008. Medical
records of patients who underwent sigmoid surgery was stratified for
the following measures; demographic characteristics, presentation to
hospital (emergency or elective), operative finding and operative
procedure, complication, co-ominous factors and outcome. Similar data
was gathered from patients who were prospectively followed up. Data was
analyzed using SPSS. Results : One hundred eighty two patients aged
10 years and above met the inclusion criteria. They had fasted 6 hours
prior to the operation and undergone both general anaesthesia and
surgery. Patients who had medical and surgical conditions that led to
nausea and vomiting were excluded. 53% of the patients were males and
43% were females. The prevalence of PONV was 40.7% within 24 hours
after surgery. Factors that were statistically significantly (p value
< 0.05) associated with PONV following univariate analysis included
: age group 20 to 30 years, female gender, history of PONV,
intra-operative use of Pethidine, type of operation (orthopaedic
surgery) and postoperative use of Pethidine. Independent predictors of
PONV include; age group of 20 to 30 years, history of PONV, and the
type of operation. Conclusion : Sigmoid volvulus is relatively rare in
our community. It commonly affect males particularly the old. Most of
the patients presented acutely, requiring immediate resuscitation and
surgical approach. In viable bowel, primary resection and anastomosis
of the twisted sigmoid is feasible as it may not adversely affect
outcome. Nevertheless colostomy should be considered if the bowel is
gangrenous or perforated. Though the disease carries a high mortality,
most of the patient who die are either older and/or have co-morbid
conditions