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Introduction: Burst abdomen can result in evisceration (protrusion of abdominal viscera), requiring immediate treatment. If, left untreated, it can cause perioperative mortality. Some studies have been conducted in the past to develop risk scoring systems to identify patients who have a significant risk of developing a burst abdomen. The Rotterdam score considers all three risk factors (i.e., preoperative, intraoperative, and postoperative) and is a standard scoring system for predicting the risk of burst abdomen in the Western population. The Krishna Institute of Medical Sciences (KIMS) 14 score compares only preoperative and intraoperative factors. Aim: To evaluate the demographic and clinical profile of patients developing burst abdomen following laparotomy for peritonitis and to assess their Rotterdam and KIMS 14 risk scores. Materials and Methods: This retrospective observational study was conducted in the Department of Surgery at GTB Hospital, New Delhi, India, from January 2024 to March 2024. The case sheet records of patients operated on in the last three years (January 2021 to December 2023) were evaluated. A total of 100 patients were enrolled as per inclusion and exclusion criteria. A total of 50 patients were classified as cases (who developed burst abdomen) and 50 patients as controls (who did not have burst abdomen). The outcome measures included demographic and clinical data of patients, associated co-morbidities, preoperative status, and intraoperative findings (organ affected, type of contamination, postoperative complications). The Rotterdam score and KIMS 14 score were calculated. For qualitative variables, the Chi-square test or Fisher’s-exact test was used. Statistical significance was set at p

Objectives: To assess the overall mental health of enucleated or eviscerated patients after high-density porous polyethylene OCULFIT implantation and external prosthesis over a 1-year follow-up. Methods: Patients with an indication of enucleation or evisceration with OCULFIT implantation were included in a prospective study. The patients completed four questionnaires regarding mental health at three different visits (baseline, 3–6 months, and 9–12 months post-surgery). The questionnaires used were the following: SF-12 for multidimensional health-related quality of life (scale 0–100); Rosemberg self-esteem scale (scale 0–40); Patients Health Questionnaire-4 (PHQ-4) (scale 0–6); and a Lifetime Major Depression and Anhedonia questionnaire (categorised in groups with/without symptoms). Results: A total of 33 patients (16 enucleations and 17 eviscerations) were included in the study. The physical domain of the SF-12 questionnaire did not change between visits, but the mental domain significantly improved from the baseline to the last visit (41.71 ± 12.72 vs. 46.80 ± 10.68, p = 0.04). The number of patients with high, moderate, and low self-esteem (Rosemberg scale) was similar between the baseline and the last visit. The depression and anxiety scores of the PHQ-4 were not significantly different among visits. The number of patients with no symptoms (depression or anhedonia) improved from the baseline (42.2%) throughout the follow-up (66.7% at the last visit). Conclusions: OCULFIT orbital implant and external prosthesis placement maintained and/or improved the quality of life related to mental health in eviscerated and enucleated eyes. The number of patients with no symptoms improved from the baseline throughout the follow-up. The patients’ self-esteem was already high before implantation and remained stable over the follow-up.

Uterine perforation is a major but rare complication of surgical abortion, with some of the dreaded complications being bowel herniation, strangulation, gangrene, and sepsis. With the legalisation of medical termination of pregnancy, such life-threatening complications have become a rarity in recent times. Usually, the patient presents with lower abdominal pain, and a history of surgical abortion may not being forthcoming at most of the time. A high index of suspicion should be kept while imaging the patient in an emergency setting, since early diagnosis is key to survival, especially if an unsafe abortion has been performed. Hereby, the authors present a case of a 30-year-old female patient presenting with non specific complaints of abdominal pain. Upon vaginal examination, a structure protruding out of the internal os (admitting the tip of a finger) was noted, and a boggy mass was felt in the pouch of Douglas. Ultrasonography and Contrast-enhanced Computed Tomography scan (CECT) performed in an emergency setting revealed uterine rupture with a rent, intra-abdominal foetal extrusion, and bowel loop herniation through the vagina. A delayed CT scan provided additional information about right ureteral injury, which was helpful in proper urological preoperative planning. In conclusion, ultrasonography and CECT imaging are useful in cases with lower abdominal pain having recent history of abortion to rule out uterine perforation and other obvious and occult associated complications for proper patient management.

Small bowel evisceration from dehiscent vaginal cuff is unusual subsequent to laparoscopic hysterectomy. This complication is seldom cited in studies and reviews. We present an uncommon case of evisceration of small bowel from vaginal cuff dehiscence (VCD). The event occurred approximately 2 hours subsequent to the first act of coitus performed 3 months after the laparoscopic hysterectomy. Patient was brought to the emergency department for primary treatment. Urgent surgical intervention was planned. Small intestine was reposed after saline wash. Repairing of the vault was done with continuous suture by polyglactin-910 braided synthetic absorbable suture no.1. Patient was sent to home after 5 days of surgery. The strength of vaginal vault in laparoscopic hysterectomy depends on technique of vaginal cuff closure and types of suture materials used during surgery. Postoperative counseling of patients for recommencing physical activity and sexual intercourse is also of utmost significance.

The purpose of the work is to evaluate the characteristics of primary posttraumatic eyeball removal in the adult population of the Krasnoyarsk Territory. Material and methods. The analysis of 87 patients’ medical documents from the Krasnoyarsk Regional Ophthalmologic Clinical Hospital has been carried out since 2003 till 2016; the primary posttraumatic eyeball removal was performed. Gender, age, place of residence, social and labor status of patients, the type and nature of the injuries that caused the eyeball removal as a primary surgical intervention have been taken into account. Results and discussion. Between 2003-2016 the proportion of primary posttraumatic removal of the eyeball was ranged from 9 % to 42.9 % of all eye removal procedures due to trauma., Their were 73 (83.9 %) men and 14 (16.1 %) women among 87 patients aged 18-88 years. Distribution by social status came up to unemployed citizens (48.3 %), officially employed - 28.8 % and pensioners - 22.9 %. Home accident trauma was more common (68.9 % of cases), criminal (24.1 %) and industrial (6.9 %) injuries were less often. The period from the eye injury moment till its removal was 0-90 days. The main causes of primary posttraumatic eye removal were eyeball destruction in 65.5 % of cases, panophthalmia was in 19.6 %, eye painful subatrophy - in 14.9 % of cases. Conclusion. Primary posttraumatic eyeball removal can be considered as a model of the entire population of post-traumatic enucleations. Specific gravity (23.9 %), increase in the frequency of primary post-traumatic eyeball removal can influence on the waiting time for traumatic enucleation in general. In the overwhelming number of injured patients, the primary removal of the eyeball is the consequence of the injury severity, in 34.5 % of cases it is due to the imperfection of medical care at various stages of its delivery.

L´éviscération transanale de l´intestin grêle par empâlement est exceptionnelle chez l´enfant. Nous rapportons l´observation d´un adolescent de 11 ans reçu à 2 heures d´une issue des anses grêles à travers l´anus suite à une chute avec réception sur un morceau de bois pointu. L´examen clinique avait objectivé un bon état général, une issue, par l´anus, d´environ 25 cm d´intestin grêle viable et un abdomen sensible dans son ensemble. Le bilan biologique préopératoire était normal et aucune imagerie n´était réalisée. Après une réanimation, l´exploration chirurgicale avait mis en évidence un liquide séro-hématique (300 ml) et une issue d´environ 60 cm d´anse grêle inflammatoire à travers une brèche d´environ 5 cm de la paroi antérieure du rectum. Une réduction des anses grêles éviscérées par traction douce, une réparation de la paroi rectale par des points séparés, une toilette et un drainage ont été réalisés. Le patient était sous antibiotique à large spectre. Les suites opératoires étaient simples avec une reprise du transit à J2 post-opératoire. La sortie a été autorisée à J7 post opératoire. Après un recul d´un mois, la patiente a été revue en consultation et l´examen clinique était normal.

The article presents the experience of surgical treatment of 51 patients who were treated at the State Institution “V.T. Zaitsev Institute of General and Emergency Surgery NAMS of Ukraine" from 2008 to 2018. with locally advanced cancer of the pelvic organs. Compression of the upper and lower urinary tract with the formation of ureterohydronephrosis was observed in 26 (50.1%) patients, acute intestinal obstruction in 22 (43.1%) patients, and formation of recto-vesicular and/or recto-vaginal fistulas in 15 (29.4 %) patients; bleeding in 14 (27.5%) patients. In 26 (50.1%) patients, 2 or more complications were present. Syndromic differentiation of treatment determined the tactics of the combined treatment, taking into account the risk of complications, which made it possible to ensure the radical removal of the primary tumor, as well as to preserve functioning of the pelvic organs when using a staged surgical treatment.

Abstract With timely recognition and surgical intervention along with administration of an antibiotic, antihistaminic, and anti‐inflammatory drugs, evisceration of umbilical content with extensive adhesion can be treated, and the outcome is also good.

Traumatic abdominal wall hernia with evisceration is an uncommon injury secondary to blunt abdominal trauma in all age groups. Bicycle handlebar injuries among children are significant causes of blunt abdominal trauma such as penetrating trauma. We present a case of evisceration in a 14-year-old child after blunt injury with handle bar. We assume that early management and prompt abdominal exploration and surgical repair provide good clinical outcome without complication.

This paper aims to report cases of spontaneous globe rupture in the blind eyes of three elderly patients with end-stage glaucoma some of which were possibly structurally compromised with topical traditional eye medications and steroids. These patients presented to the ophthalmology department of the University of Benin Teaching Hospital with a history of bleeding from one of their eyes and no antecedent history of trauma. They were known glaucoma patients who were blind with previously recorded high intraocular pressures. Evisceration was performed for two of the cases while enucleation was performed for one shortly after presentation.

To identify the major source of Salmonella contamination in a pig slaughterhouse, samples were collected from the clean and unclean area and Salmonella isolates were further typed. Carcasses entering the clean area showed a Salmonella contamination rate of 96.7% in the oral cavity and 55.0% in the rectum content samples. Evisceration seemed not to be critical as the contamination rate of the carcasses was similar before (16.7%) and after (18.3%) this slaughter step. In the unclean area, a limited number of oral cavity samples were positive after bleeding, while a dramatic increase of positives was observed after dehairing. Salmonella was detected in up to 0.01 mL of the recycled water collected from the dehairing machine. Genotyping of Salmonella isolates showed that similar pulsotypes were present in the oral cavity and recycled water. Based on these observations it can be concluded that the recycled water used in the dehairing machine was the major source for the carcass contamination in this slaughterhouse.

Blunt traumatic abdominal wall disruptions associated with evisceration (abdominal wall injury grade type VI) are very rare. We describe a case of large traumatic abdominal wall disruption with bowel evisceration and complete transection of jejunum and sigmoid colon that occurred after a 30-year-old male sustained run over injury to abdomen. Abdominal exploration and primary end to end jejuno-jejunal and colo-colic anastomosis were done. Staged management of giant abdominal wall defect was performed without any plastic reconstruction with good clinical outcome.

Il s'agit d'une patiente de 42 ans, deuxième geste, deuxième parité, admise pour prise en charge d'un myome utérin interstitiel. Les suites opératoires ont été marquées par une infection cutanée associée à une éventration utérine. A l'examen, la patiente était fébrile à 39.5'C, associée à une éviscération de l'utérus avec issu de pus verdâtre à travers le site opératoire. Le bilan biologique réalisé montrait un taux d'hémoglobine à 12g/dl, une hyperleucocytose à polynucléaire neutrophile 15000/uL et la C Réactive Protéine à 320 mg/l. Ces résultats ont conduit à la réalisation d'un complément TDM qui a montré une fistule utero-pariétale avec une éviscération utérine, sans complication digestive associée. L'utérus était également disroté avec un contenu hydro-aérique, faiblement rehaussé en périphérie après contraste, confirmant une surinfection associée. La prise en charge chirurgicale a été effectuée avec curetage de la cavité utérine à travers la brèche de perforation qui a été par la suite suturée. Ce cas met en exergue une complication rare de perforation utérine dans les suites opératoires d'une myomectomie utérine.

Multiple myeloma cripples the human body in many ways, one of them being decreased immunity. Infections occurring spontaneously can increase the morbidity. We report a case of an elderly lady with multiple myeloma on treatment and uncontrolled diabetes, who developed loss of vision, swelling and redness of left eye of 4 days duration. There was no history of injury or entry of a foreign body. She also had left arm cellulitis. Ocular examination revealed visual acuity of 6/36 in right eye and no perception of light in left eye. Anterior segment of the right eye was insignificant while the left eye showed features suggestive of panophthalmitis. B scan revealed choroidal detachment and confirmed panophthalmitis. She underwent evisceration of the left eye. The cause of spontaneous infections is an immunocompromised state due to multiple myeloma and uncontrolled diabetes. This case report highlights the propensity of multiple myeloma to cause infections of the eye debilitating enough to cause severe visual morbidity.

This article aims to present the importance, indication and contraindication of enucleation and evisceration. Enucleation is an operation to remove all parts of the eyeball, but evisceration is the removal of some parts of the eyeball, leaving the sclera, extraocular muscles and optic nerve intact. Therefore, evisceration is an absolute contraindication for diagnosed or suspected cases of intraocular malignancy. Some cases are controversial as to whether or not to perform evisceration or enucleation. If the disease has no contraindication for evisceration, the surgeon should perform evisceration as the first choice. Although the risk for sympathetic ophthalmia exists, this is very rare. A good surgical technique can create the ideal anophthalmic socket and fit a prosthesis to look like a normal eye. Evisceration also has a better outcome in cosmesis and prosthetic movement. Patients with an anophthalmic socket have some complications that the ophthalmologists should take into account including wearing polycarbonate glasses to prevent an accident from damaging the other eye.

Objective: To analyze the results from 111pediatric patients who underwent enucleationor evisceration at Barraquer Clinic, during 11years (1990- 2000), determining the kind ofcorrection used and complications associatedwith the procedure.Methods: Retrospective study of medicalrecords from all patients under 18 years whounderwent mentioned surgery. Demographicdata, diagnosis, associated ophthalmic surgeries,implants or grafts characteristics, follow upperiod and postoperative complications weredetermined in all patients.Results: A total of 55 enucleations and 56eviscerations were done. In only one case neitherimplant nor graft was placed. During thefirst 4 years of the study, lipodermal grafts correspondedto 25,45% and nylon implants to72,72% of the totality, while in the last 7 yearshydroxyapatite implants corresponded to78,57% of the cases. 17 patients (15,32%) hadcomplications that required surgical correction,with no significant statistical difference betweenthe types of corrections placed.Conclusions: Hydroxyapatite implants givean excellent anophthalmic orbit reconstruction forpediatric population, and improve esthetic andmotility results. Other correction types likelipodermal grafts still constitute an excellent alternativein our environment, considering theirlower costs. Although we observed some complicationswith the different correction methods, onlya few cases required surgical intervention. The rateof complications increased in younger patients.

L�evisceration transanale de l�intestin grele au cours d�un traumatisme ferme de l�abdomen est une situation exceptionnelle. Nous rapportons le cas d�une fille de 7 ans, recue pour un etat de choc hemorragique avec une evisceration transanale de l�intestin grele suite a une contusion de l�abdomen. Ce tableau clinique est survenu au decours d�un accident de la circulation. La laparotomie exploratrice permettait de decouvrir une plaie longitudinale de la face anterieure du rectum, situee au dessus de la reflexion peritoneale, a travers laquelle passaient les anses greles. Une suture de la plaie rectale associee a une ileostomie double apres resection du grele eviscere et un a drainage du cul-de-sac de Douglas ont ete realises. L�enfant est decede en postoperatoire precoce. A travers cette observation, les auteurs se proposent de revoir les cas precedemment decrits et de discuter les options therapeutiques.

Paciente masculino de 27 años de edad, trabajador agrícola, que fue ingresado en el Hospital Militar Central "Dr. Carlos J. Finlay" por haber sufrido una herida penetrante por arma de fuego, producida por la impulsión retrógrada del percutor al disparar una escopeta artesanal de cacería, que provocó estallido del globo ocular izquierdo, fractura de la pared externa de la órbita y heridas palpebrales. Se retiró el cuerpo extraño, se completó la evisceración del ojo izquierdo, se recolocó el fragmento fracturado de la órbita en posición anatómica, se regularizaron los tejidos blandos intra y periorbitarios, preparando la cavidad orbitaria para la colocación posterior de la prótesis; y se realizó la hemostasia, la exploración de la cavidad neoformada por el cuerpo extraño en los tejidos blandos de la región fronto-temporal y la plastia palpebral. Se logró con éxito la reconstrucción palpebral y con posterioridad, la rehabilitación con fines estéticos mediante prótesis ocular.