Hanief Mohamed Dar

Role of laparoscopy in nonspecific abdominal pain

Objective: The aim was to determine the role of laparoscopy in the management of nonspecific abdominal pain (NSAP). Background: NSAP constitutes a good proportion of surgical admissions, both in emergency and elective settings with considerable diagnostic dilemma. Patients and Methods: All patients who presented with pain abdomen with no immediate cause and were labeled as NSAP after clinical assessment and investigations and following that underwent laparoscopy to make a definitive diagnosis were included in the study. Results: A total of 88 patients were included in the study. There were 59 (67%) females and 29 (33%) males. The mean age was 26 years (range 18-58 year). The common mode of admission was out-patient department 69 (78.4%) patients. Twenty-five (28.4%) patients presented with NSAP in lower abdomen, followed by 21 (23.8%) with right lower abdominal pain and 19 (21.5%) with central pain radiating to right lower abdomen. Diagnosis was established in 75 (85.2%) patients. In 13 (14.7%) no pathology was found. The most common diagnosis was pathology of appendix in 29 (32.9%) patients followed by pelvic pathology in 18 (20.4%) and abdominal tuberculosis in 14 (15.9%) patients. Most 37 (42%) of the patients stayed in the hospital for 24 h. There was no readmission and no major postoperative complications. Conclusions: Laparoscopy has a definitive role in diagnostic dilemma associated with NSAP. It has at the same time role in treatment of the condition; hence laparoscopy has a diagnostic and a therapeutic implication in management of NSAP.

Penile fracture; three years’ experience from a tertiary care centre

The first documented report of this condition was credited to Albulkasem, the Arab Physician, in Cordoba more than 1000 years ago. Penile fracture is defined as a traumatic rupture of the tunica albuginea of one or both corpora cavernosa of an erect penis. There may be an associated injury to the corpus spongiosum or urethra. The condition is under-reported, and certainly not as rare as has been claimed. Although the penis has no bones, but the situation occurring in an erect penis mimics fracture sequences that occur in bones. In penile fracture, the cause of rupture is buckling of the tunica albuginea during erection, tunica stretches and changes its thickness from 2mm to 0.25mm, losses elasticity, and due to that penile fracture can occur by implication of blunt force or bending. Fracture of the penis usually results from direct trauma during sexual intercourse, masturbation, bending ABSTRACT