Research Article
Diagnostic Significance of Laboratory Tests in Correlating with Findings of Exploratory Abdominal Surgery Following Trauma
Issue:
Volume 13, Issue 6, December 2025
Pages:
152-161
Received:
27 October 2025
Accepted:
6 November 2025
Published:
9 December 2025
Abstract: Background: Blunt abdominal trauma (BAT) is a common cause of intra-abdominal injuries and poses significant diagnostic challenges. Laboratory and imaging investigations are essential in guiding the management of these patients. Objective: This study aimed to evaluate the diagnostic significance of laboratory tests in correlation with findings from exploratory abdominal surgery following trauma. Methods: This descriptive cross-sectional study was conducted in the Department of Surgery, Rangpur Medical College and Hospital, Rangpur, Bangladesh, from July 2020 to December 2020. A total of 50 patients diagnosed with blunt abdominal trauma and requiring exploratory laparotomy were included in the study. Results: The majority of patients were aged 31–40 years (42%) with a male predominance (70%). Abdominal pain was the most common presenting symptom (100%), followed by abdominal distension (76%) and vomiting (24%). Clinical examination revealed tenderness in 90%, guarding/rigidity in 78%, and rebound tenderness and absent bowel sounds in 70% of patients. Laboratory abnormalities included deranged INR in 74%, prolonged APTT in 70%, elevated AST in 34%, ALT in 30%, and raised amylase and lipase in 48% of patients. Imaging detected free fluid on USG in 80% and haemoperitoneum on CT in 94% of cases. Small bowel was the most commonly injured organ (54%), followed by liver (20%), spleen (16%), mesentery (12%), duodenum (10%), colon (6%), and stomach (4%). Most injuries were isolated (76%), with grade II small bowel and duodenal injuries predominating. Patients aged 18–40 years exhibited the highest frequency of biochemical and imaging abnormalities, correlating with small bowel injuries (P < 0.00001). Conclusion: Laboratory and imaging investigations provide valuable diagnostic support in BAT but should complement clinical evaluation. Younger patients are at higher risk for small bowel injuries and exhibit more pronounced biochemical derangements. Early recognition and correlation with surgical findings are crucial to improve outcomes.
Abstract: Background: Blunt abdominal trauma (BAT) is a common cause of intra-abdominal injuries and poses significant diagnostic challenges. Laboratory and imaging investigations are essential in guiding the management of these patients. Objective: This study aimed to evaluate the diagnostic significance of laboratory tests in correlation with findings from...
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Review Article
The Evolving Role of Heller-Dor in the Poem Era
Issue:
Volume 13, Issue 6, December 2025
Pages:
162-168
Received:
30 October 2025
Accepted:
26 November 2025
Published:
20 December 2025
DOI:
10.11648/j.js.20251306.12
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Abstract: Objectives: Peroral endoscopic myotomy (POEM) has emerged as an alternative to laparoscopic Heller myotomy (LHM), but concerns remain regarding postoperative reflux and outcomes in advanced megaesophagus. We evaluated the effectiveness and safety of an extended LHM combined with a modified Dor fundoplication in a contemporary cohort of patients with achalasia. Methods: This retrospective series included 72 consecutive patients with idiopathic or Chagas-related achalasia treated at a university hospital and a private clinic between January 2017 and February 2025. All underwent extended esophageal myotomy (6cm above and 3cm below the esophagogastric junction) with a two-row modified Dor fundoplication. Diagnosis was based on clinical, endoscopic, radiologic, and manometric criteria. Symptom severity was assessed using pre- and postoperative Eckardt scores; scores >3 were considered treatment failure. Megaesophagus grade was determined radiologically according to the Chicago Classification and correlated with outcomes. Patients were followed clinically and endoscopically for up to 45 months. Results: Dysphagia (79%), weight loss (58.3%), and regurgitation (56.9%) were the most frequent preoperative symptoms. The mean preoperative Eckardt score was 5.98, decreasing to 0.52 postoperatively. Occasional residual symptoms were reported by 13 patients (17.33%), but only one (1.4%) met criteria for therapeutic failure, yielding a success rate of 98.6%. There was no mortality. One patient developed atrial fibrillation on postoperative day 1, successfully treated with anticoagulation. No reinterventions were required, and no patient reported symptoms of gastroesophageal reflux during follow-up. Megaesophagus grade, including advanced (III–IV) disease, was not associated with outcome. Conclusions: Extended laparoscopic Heller myotomy with modified Dor fundoplication is a safe and highly effective procedure for achalasia across all degrees of megaesophagus, with excellent symptom control, minimal morbidity, and an apparent protective effect against postoperative reflux. These findings support the continued central role of Heller–Dor in the surgical management of achalasia in the POEM era.
Abstract: Objectives: Peroral endoscopic myotomy (POEM) has emerged as an alternative to laparoscopic Heller myotomy (LHM), but concerns remain regarding postoperative reflux and outcomes in advanced megaesophagus. We evaluated the effectiveness and safety of an extended LHM combined with a modified Dor fundoplication in a contemporary cohort of patients wit...
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Review Article
Research and Analysis on the Progress of Surgical Treatment for Mixed Hemorrhoids
Issue:
Volume 13, Issue 6, December 2025
Pages:
169-174
Received:
23 November 2025
Accepted:
3 December 2025
Published:
20 December 2025
DOI:
10.11648/j.js.20251306.13
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Abstract: Mixed hemorrhoids is one of the common and frequently occurring diseases in anorectal department. In the early stage, the symptoms are mild or even asymptomatic. In most cases, conservative treatment with medical drugs can be used to improve the symptoms. However, with the development of the disease, the symptoms will gradually become obvious, and the effect of conservative medical treatment will become worse. For mixed hemorrhoids in stages III and IV, surgery is often required in the end. At present, there are various surgical treatments for mixed hemorrhoids. The traditional mixed hemorrhoids external dissection and internal ligation, closed hemorrhoidectomy, and simple external hemorrhoidectomy are mainly used. With the development of technology, the experience is constantly summarized and the surgical methods are improved, such as circular hemorrhoidectomy, selective hemorrhoidectomy, ligation, etc. The surgical treatment of mixed hemorrhoids has gradually changed from the traditional simple removal of hemorrhoid tissue to a new mode based on correcting the hypertrophy of pathological tissue and preserving the complete anal pad tissue. This article will explore the application status, advantages and disadvantages of traditional surgery and minimally invasive surgery in the treatment of mixed hemorrhoids, and analyze the applicability of different surgical methods for patients with different disease severity. By searching and reviewing the relevant literatures at home and abroad in recent years, this paper systematically reviews the latest progress of surgical treatment of mixed hemorrhoids, so as to provide scientific basis and reference value for clinical treatment.
Abstract: Mixed hemorrhoids is one of the common and frequently occurring diseases in anorectal department. In the early stage, the symptoms are mild or even asymptomatic. In most cases, conservative treatment with medical drugs can be used to improve the symptoms. However, with the development of the disease, the symptoms will gradually become obvious, and ...
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,
Atiqul Maula Omar Ibrahim Shamsi
