Background: Corrosive substances can cause serious injuries of the upper gastrointestinal tract and may lead to death. Acute corrosive poisonings are caused by ingestion of corrosive chemicals which are mostly used as household agents and are ingested accidentally or suicidal intentionally. The objectives of the present study were to evaluate and compare the medium term outcomes of the multi modal treatment used for patients presenting with corrosive upper gastrointestinal strictures and to study the demographic and clinico- pathological profile of the patients of corrosive upper gastro intestinal tract strictures.Methods: A combined retrospective and prospective study was carried out on departmental database and patient presenting with corrosive upper gastrointestinal stricture from December 2010 to July 2019 in the Department of Surgical Gastroenterology at King George's Medical University for a period of 9 years.Results: Corrosive ingestion was found to be more prevalent in age group of 15-65 years with higher incidence to be found in females compared to males. Majority of ingestion of corrosive substances are found to be suicidal by adults.Conclusions: India has high incidence of corrosive ingestion mainly suicidal and homicidal indent. Endoscopic dilatation of esophageal strictures is safe and effective therapy and should be first line therapy in patients with esophageal strictures and surgery should be considered only in patients who have technical and clinical failure on endoscopic dilatation.

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Background: Acute pancreatitis is one of the leading causes of hospitalization amongst all gastrointestinal disorders with high burden of morbidity and mortality. Predicting the progression of AP in terms of course and outcome to determine suitable management strategy and level of care is challenging. A number of predictor models are developed to predict the severity of acute pancreatitis but they vary in their definitions of severity. HAPS have been proposed as a simple scoring tool for assessment of severity and prognosis of acute pancreatitis. Thus, the aim of present study was to investigate the usefulness of HAPS predictor model against APACHE II model.Methods: Current investigation was a hospital based prospective study conducted on 80 proven cases of acute pancreatitis at K. K. hospital, Uttar Pradesh. The serum amylase and lipase levels of all enrolled patients, were tested and measured at admission, and at 48 and 72 hours post admission. The pancreatitis-specific clinical investigations like; HAPS, APACHE II were calculated and assessed statistically in terms of sensitivity, specificity, positive and negative predictive values and accuracy.Results: The findings of present investigation revealed that amongst the two scoring systems, APACHE II was superior predictor model in terms of sensitivity and specificity for various outcomes like severe acute pancreatitis, hospital stay >7 days and in-hospital mortality. However, HAPS exhibited high specificity for all the outcomes.Conclusions: HAPS can be recommended as a useful tool for early evaluation of acute pancreatitis in patients specifically in primary care settings of developing countries like India.

Transanal evisceration of the small bowel is a rare surgical emergency. Rectal perforation in such cases is usually due to an underlying rectal prolapse. We report a case of a middle aged (45 years) male with spontaneous rectal perforation and transanal evisceration of the small bowel. Approximately 150 cm of small bowel had eviscerated transanally and the patient required emergent abdominal exploration, reposition of the small bowel, and repair of the rectal perforation. Small bowel evisceration through the anal verge is an emergent condition and the aim was to prevent life threatening complications related to sepsis.

Objective The objective of this article is to evaluate the role of synthetic mesh versus biological mesh in repair of potentially contaminated and contaminated abdominal wall hernias/defects. Method Analysis was conducted according to PRISMA guidelines. Systematic search of medical databases like MEBASE, MEDLINE and pubmed was performed to find studies exclusively comparing the use of synthetic mesh versus biological mesh in repairing the potentially contaminated and contaminated complex abdominal wall hernia/defects. Standard medical electronic databases were searched with the help of local librarian and relevant published randomized controlled trials (RCT) were shortlisted according to the inclusion criteria. The analysis of the pooled data was done using RevMan statistical software. Result Three RCTs and 10 comparative studies on 1138 fulfilled the inclusion criteria. In the random effects model analysis, the use synthetic mesh for complex abdominal wall hernia/defect repair in contaminated or potentially contaminated zones reduce the risk of hernia recurrence [odds ratio 0.44, 95% CI (0.33–0.60), z= 5.37, p=0.00001] compared to implantation of biological mesh. Moreover, risk of surgical site infection was statistically higher [odds ratio 0.66, 95% CI (0.47–0.92), z=2.44, p=0.01] following the use of biological mesh. There was no heterogeneity (Tau2 = 0.10; Chi2= 16.15, df = 9 (p=0.06; I2 = 44%) among included studies. Conclusion Use of biological mesh for complex abdominal wall hernia/defect repair in potentially contaminated and contaminated situations failed to demonstrate any superiority over conventional synthetic mesh in both benchmark variables of surgical site infection and hernia recurrence.