Papers by Jothiprasad Venkatesan
Journal of Digestive Endoscopy, 2021
Colovesical fistula (CVF) is an abnormal communication between bowel and urinary bladder. Most co... more Colovesical fistula (CVF) is an abnormal communication between bowel and urinary bladder. Most common cause is complicated colonic diverticular disease. The treatment of choice for CVF is surgery. Conservative treatment is reserved for highly selected patients who are unfit for definitive surgery. We report the case of an 86-year-old gentleman with multiple comorbidities, who presented with pneumaturia, fecaluria, and recurrent urinary tract infection. He was diagnosed to have sigmoid colonic diverticulosis with a CVF and was successfully managed with the novel combined endoscopic approach (a simultaneous cystoscopy and flexible colonoscopy), which could be the first to be reported from India.
Cystic hygroma is a congenital malformation of the lymphatic system that occurs in children less ... more Cystic hygroma is a congenital malformation of the lymphatic system that occurs in children less than 2 years of age. Although it is well recognised in paediatric practice, it seldom presents de novo in adults. These are commonly present in head and neck but can occur anywhere. Cystic hygroma is very rare in adults, but it should be considered in the differential diagnosis of adult neck swellings. Patients presenting with a painless, soft, fluctuant and enlarging neck mass should have a careful history and physical examination along with radiological imaging to help in diagnosis. Here, we are reporting a case of cystic hygroma in a 42-year-old female patient in the neck region.
Groove pancreatitis (GP) is a rare type of segmental chronic pancreatitis that affects the anatom... more Groove pancreatitis (GP) is a rare type of segmental chronic pancreatitis that affects the anatomical area between the pancreatic head, the duodenum, and the common bile duct, called - “the groove area”. It remains largely an unfamiliar entity to most physicians and is often misdiagnosed as pancreatic malignancy or an autoimmune pancreatitis. We report three cases diagnosed as GP and in our department and their management. The first and second patient had recurrent episodes of abdomen pain and vomiting, while the other one was asymptomatic with steatorrhoea. The second and third patients had history of long-standing alcohol intake. First two cases underwent pancreatico-duodenectomy for intractable recurrent pain and other patient is doing well with conservative management.
International Journal of Surgery Science, 2020
Background: Diabetic foot ulcers (DFU) are commonly encountered during clinical practice and are ... more Background: Diabetic foot ulcers (DFU) are commonly encountered during clinical practice and are often difficult to treat. The aim of this study was to evaluate the effectiveness of octenidine dihydrochloride dressing and saline dressing in healing diabetic foot ulcers. Methods: A total of 50 patients (25 patients in each group of octenidine dihydrochloride and saline dressing group) with complaints of chronic diabetic foot ulcer attending surgery outpatient department of Sri Ramakrishna Hospital were included in this prospective comparative study from September 2018 to November 2019. Dressings were done on daily basis for a period of 6 weeks, and the results were compared on 2nd, 4th and 6th week, using reduction in surface area of the wound as parameter of healing process. Other parameters such as age, gender, associated co morbidities were assessed. The mean surface area of wound in saline group was: baseline-10.2 sq.cm, 2nd week-9.8 sq.cm, 4th week-8.6 sq.cm, 6th week-7.5 sq.cm; While in octenidine dihydrochloride group was: baseline-11.8 sq.cm, 2nd week-9.6 sq.cm, 4th week-6.8 sq.cm, 6th week-5.2 sq.cm. After 6 weeks, the mean reduction in surface area of wound is more in the octenidine dihydrochloride dressing group compared with the slaine dressing group and the results are statistically significant at a p<0.05. Conclusions: octenidine dihydrochloride dressing is more effective than saline dressing in achieving complete healing, reducing wound surface area, and decreasing morbidity in patients with DFU.
Journal of Medical Science And clinical Research, 2020
Fistula-in ano is an abnormal communication between the anal canal or rectum and perianal skin, w... more Fistula-in ano is an abnormal communication between the anal canal or rectum and perianal skin, which causes a chronic inflammatory response. The most common cause is nearly always by a previous ano-rectal abscess. This study was intended for a clinico-pathological analysis of fistula-in ano and their diagnostic and treatment modalities based on various demographic features and associated conditions. 150 patients were selected who were diagnosed as fistula-in ano admitted and underwent surgical interventions during December 2017 to June 2019. Data related to objectives of the study were collected and analysed. Patients belonging to the age group 31-50 constituted the majority (60%). There was male predominance with ratio of 2.4:1. Half (49.3%) of the cases had DM and 65.3% had perianal abscess before. Most fistula were low anal (80%). MRI Fistulogram was the most sensitive investigation. Fistulectomy was done in three-fourth (n-113, 75.3%). There was no complication in majority and most common complication observed was wound infection (15.3%). In majority (81.3%) of the cases the surgical wound healed by 4 weeks. There was statistically significant difference (p-0.001) in time taken to heal between diabetic and non-diabetic groups. Non-specific inflammation was the histopathology report in 146(97.3%) cases but Tuberculosis was seen in 2 cases.
Journal of Medical Science And clinical Research, 2020
Peripheral vascular disease (PVD) is stenosis of arteries supplying other than those in brain and... more Peripheral vascular disease (PVD) is stenosis of arteries supplying other than those in brain and heart. The prevalence of PVD is very high in general practice and it is under-diagnosed most of the times. Simple investigation tool like Ankle Brachial Index (ABI) can be used to screen patients with high risk factors and diagnose the disease in the early phase itself, so that morbidity associated with the disease can be reduced.
International Surgery Journal
Blunt injury abdomen (BIA) is an ever-increasing problem. Isolated injury to duodenum following B... more Blunt injury abdomen (BIA) is an ever-increasing problem. Isolated injury to duodenum following BIA is rare (1-4%). It can be a challenge to the surgeon and failure to manage it properly can lead on to devastating results. Blunt duodenal injury can occur in isolation or with pancreatic injury. We report a case of an isolated transection of third part of the duodenum following BIA. Initial clinical changes in isolated duodenal injury may be subtle before life-threatening peritonitis develops. High index of suspicion, knowledge of mechanism of injury, physical examination and proper imaging techniques are the key in early detection of duodenal injury.
Fistula-in ano is an abnormal communication between the anal canal or rectum and perianal skin, w... more Fistula-in ano is an abnormal communication between the anal canal or rectum and perianal skin, which causes a chronic inflammatory response. The most common cause is nearly always by a previous ano-rectal abscess. This study was intended for a clinico-pathological analysis of fistula-in ano and their diagnostic and treatment modalities based on various demographic features and associated conditions. 150 patients were selected who were diagnosed as fistula-in ano admitted and underwent surgical interventions during December 2017 to June 2019. Data related to objectives of the study were collected and analysed. Patients belonging to the age group 31-50 constituted the majority (60%). There was male predominance with ratio of 2.4:1. Half (49.3%) of the cases had DM and 65.3% had perianal abscess before. Most fistula were low anal (80%). MRI Fistulogram was the most sensitive investigation. Fistulectomy was done in three-fourth (n-113, 75.3%). There was no complication in majority and most common complication observed was wound infection (15.3%). In majority (81.3%) of the cases the surgical wound healed by 4 weeks. There was statistically significant difference (p-0.001) in time taken to heal between diabetic and non-diabetic groups. Non-specific inflammation was the histopathology report in 146(97.3%) cases but Tuberculosis was seen in 2 cases.
Cystic hygroma is a congenital malformation of the lymphatic system that occurs in children less ... more Cystic hygroma is a congenital malformation of the lymphatic system that occurs in children less than 2 years of age. Although it is well recognised in paediatric practice, it seldom presents de novo in adults. These are commonly present in head and neck but can occur anywhere. Cystic hygroma is very rare in adults, but it should be considered in the differential diagnosis of adult neck swellings. Patients presenting with a painless , soft, fluctuant and enlarging neck mass should have a careful history and physical examination along with radiological imaging to help in diagnosis. Here, we are reporting a case of cystic hygroma in a 42-year-old female patient in the neck region.
Fournier's gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genital... more Fournier's gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum. It is predominantly a disease of males but very rarely can occur in females also. It is a surgical emergency. An early diagnosis including evaluation of predisposing and etiological factors, metabolic and physiological parameters with prompt resuscitation, aggressive surgical debridement, broad-spectrum antibiotic coverage, and continuous monitoring of all the parameters is essential for a good outcome. This will reduce the mortality and morbidity of the disease. In this study we are reporting Fournier's gangrene in a 56 years old diabetic female who was treated successfully with good outcome.
Peripheral vascular disease (PVD) is stenosis of arteries supplying other than those in brain and... more Peripheral vascular disease (PVD) is stenosis of arteries supplying other than those in brain and heart. The prevalence of PVD is very high in general practice and it is under-diagnosed most of the times. Simple investigation tool like Ankle Brachial Index (ABI) can be used to screen patients with high risk factors and diagnose the disease in the early phase itself, so that morbidity associated with the disease can be reduced.
Groove pancreatitis (GP) is a rare type of segmental chronic pancreatitis that affects the anatom... more Groove pancreatitis (GP) is a rare type of segmental chronic pancreatitis that affects the anatomical area between the pancreatic head, the duodenum, and the common bile duct, called-"the groove area". It remains largely an unfamiliar entity to most physicians and is often misdiagnosed as pancreatic malignancy or an autoimmune pancreatitis. We report three cases diagnosed as GP and in our department and their management. The first and second patient had recurrent episodes of abdomen pain and vomiting, while the other one was asymptomatic with steatorrhoea. The second and third patients had history of long-standing alcohol intake. First two cases underwent pancreatico-duodenectomy for intractable recurrent pain and other patient is doing well with conservative management.
Background: Diabetic foot ulcers (DFU) are commonly encountered during clinical practice and are ... more Background: Diabetic foot ulcers (DFU) are commonly encountered during clinical practice and are often difficult to treat. The aim of this study was to evaluate the effectiveness of octenidine dihydrochloride dressing and saline dressing in healing diabetic foot ulcers. Methods: A total of 50 patients (25 patients in each group of octenidine dihydrochloride and saline dressing group) with complaints of chronic diabetic foot ulcer attending surgery outpatient department of Sri Ramakrishna Hospital were included in this prospective comparative study from September 2018 to November 2019. Dressings were done on daily basis for a period of 6 weeks, and the results were compared on 2nd, 4th and 6th week, using reduction in surface area of the wound as parameter of healing process. Other parameters such as age, gender, associated co morbidities were assessed. Results: The mean surface area of wound in saline group was: baseline-10.2 sq.cm, 2nd week-9.8 sq.cm, 4th week-8.6 sq.cm, 6th week-7.5 sq.cm; While in octenidine dihydrochloride group was: baseline-11.8 sq.cm, 2nd week-9.6 sq.cm, 4th week-6.8 sq.cm, 6th week-5.2 sq.cm. After 6 weeks, the mean reduction in surface area of wound is more in the octenidine dihydrochloride dressing group compared with the slaine dressing group and the results are statistically significant at a p<0.05. Conclusions: octenidine dihydrochloride dressing is more effective than saline dressing in achieving complete healing, reducing wound surface area, and decreasing morbidity in patients with DFU.
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Papers by Jothiprasad Venkatesan