Background: Umbilical endometriosis, a rare benign condition, is clinically difficult to differentiate from other diseases that result in the formation of an umbilical nodule. It is caused by the presence of ectopic e...Background: Umbilical endometriosis, a rare benign condition, is clinically difficult to differentiate from other diseases that result in the formation of an umbilical nodule. It is caused by the presence of ectopic endometrial tissue in the umbilicus, which overtly presents as a painful, discoloured swelling in the umbilicus. However, in our case the presentation wasn’t as obvious. The endometrial tissue was embedded within an umbilical hernia. Case Summary: Our patient was a 37-year-old female with a past medical/surgical history of a subtotal colectomy for ulcerative colitis in 2001 followed by an ileo-rectal anastomosis. 17 years later, she was referred to the surgical outpatient clinic from GP practice with a painful umbilical/incisional hernia surrounding the previous scar and just above the umbilicus, this pain, particularly worsening during her menstrual cycle. Multiple blood tests and ultrasound scans of her abdomen failed to diagnose a cause for her agony which mandated an elective excision of the swelling. This successfully resolved her symptoms. Conclusion: Umbilical endometriosis is a potential diagnosis in females with a painful umbilical swelling, imaging has no diagnostic role and excision is the definitive treatment.展开更多
Introduction: Management of wounds is one of the commonest, often quite challenging as well, in surgical practice. Dressing is an essential component of wound management. Given its importance in achieving wound healin...Introduction: Management of wounds is one of the commonest, often quite challenging as well, in surgical practice. Dressing is an essential component of wound management. Given its importance in achieving wound healing and its complications, methods of dressing have been under constant review since time immemorial. Many innovative techniques of wound dressing have been introduced for quick and problem-free wound healing. Vacuum Assisted Closure (VAC) is one of such methods. Objective: To determine whether VAC can help in reducing the healing time of open wounds. Study Design: Quasi-experimental study. Setting: Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad. Patients and Methods: 120 patients with open wounds, surgical or accidental, were included in the study. They were alternatively assigned to either VAC (Group I) 2 or WMD {wet to moist dressing} (Group II). In both groups, the wounds were assessed for surface area, depth and percentage of granulation every 48 hours for 15 days. Mean change in above wound parameters at the end of study period was calculated. The difference between the two groups was statistically analyzed by applying student T test. P value less than 0.05 was considered significant. Results: In Group I, at the end of the study period, mean reduction in the wound surface area and volume was 39.4% and 60.3% respectively, while granulation tissue formation was 59.7%. In Group II, the respective figures were 26.9%, 38.2% and 24.5%. The difference between the two groups was statistically significant (P Conclusion: VAC was more effective than WMD in terms of reduction in wound surface, depth and degree of granulation tissue formation. VAC thus can be usefully employed for achieving speedy wound healing.展开更多
文摘Background: Umbilical endometriosis, a rare benign condition, is clinically difficult to differentiate from other diseases that result in the formation of an umbilical nodule. It is caused by the presence of ectopic endometrial tissue in the umbilicus, which overtly presents as a painful, discoloured swelling in the umbilicus. However, in our case the presentation wasn’t as obvious. The endometrial tissue was embedded within an umbilical hernia. Case Summary: Our patient was a 37-year-old female with a past medical/surgical history of a subtotal colectomy for ulcerative colitis in 2001 followed by an ileo-rectal anastomosis. 17 years later, she was referred to the surgical outpatient clinic from GP practice with a painful umbilical/incisional hernia surrounding the previous scar and just above the umbilicus, this pain, particularly worsening during her menstrual cycle. Multiple blood tests and ultrasound scans of her abdomen failed to diagnose a cause for her agony which mandated an elective excision of the swelling. This successfully resolved her symptoms. Conclusion: Umbilical endometriosis is a potential diagnosis in females with a painful umbilical swelling, imaging has no diagnostic role and excision is the definitive treatment.
文摘Introduction: Management of wounds is one of the commonest, often quite challenging as well, in surgical practice. Dressing is an essential component of wound management. Given its importance in achieving wound healing and its complications, methods of dressing have been under constant review since time immemorial. Many innovative techniques of wound dressing have been introduced for quick and problem-free wound healing. Vacuum Assisted Closure (VAC) is one of such methods. Objective: To determine whether VAC can help in reducing the healing time of open wounds. Study Design: Quasi-experimental study. Setting: Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad. Patients and Methods: 120 patients with open wounds, surgical or accidental, were included in the study. They were alternatively assigned to either VAC (Group I) 2 or WMD {wet to moist dressing} (Group II). In both groups, the wounds were assessed for surface area, depth and percentage of granulation every 48 hours for 15 days. Mean change in above wound parameters at the end of study period was calculated. The difference between the two groups was statistically analyzed by applying student T test. P value less than 0.05 was considered significant. Results: In Group I, at the end of the study period, mean reduction in the wound surface area and volume was 39.4% and 60.3% respectively, while granulation tissue formation was 59.7%. In Group II, the respective figures were 26.9%, 38.2% and 24.5%. The difference between the two groups was statistically significant (P Conclusion: VAC was more effective than WMD in terms of reduction in wound surface, depth and degree of granulation tissue formation. VAC thus can be usefully employed for achieving speedy wound healing.
