Background: Peptic ulcer perforation management is still an enigma. Though the overall incidence has been reduced worldwide due to wide use of anti-ulcerants, still it is not uncommon. But there is a debate regarding its conservative management over surgical management. Objective: To determine whether surgery could be avoided in selected patients with perforated peptic ulcer disease Methods: This study was conducted in the department of Surgery of Sir Salimullah Medical College and Mitford Hospital during the period from 1st March 2016 to 31st August 2016. After approval from the institutional ethics committee, 30 patients of suspected perforated peptic ulcer disease were successively assigned in this study on clinical and radiological basis. All were given non-operative regimen up to 24 hours. Then they were closely monitored to see improvement of clinical condition or development of any complication. Non-operative treatment was abandoned if the patient failed to improve or deteriorated within 24 hours of non-operative treatment. The data were collected by active participation of patients’ interview in preformed data collection sheet. Results: The data analysis of 30 patients yielded that most of them (86.67%) recovered well after receiving non-operative management, whereas only 4 patients (13.33%) showed no progression and were treated by laparotomy. 73.08% patients with uneventful outcome left the hospital within 10 days of admission and the others were a little late to leave. Conclusion: Patients with perforated peptic ulcer disease can be effectively treated by conservative approach in properly selected cases by proper monitoring under strict supervision of an experienced consultant. Journal of Surgical Sciences (2018) Vol. 22 (2) : 95-98

Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. This study was carried out to find out various risk factors of burst abdomen following emergency laparotomy, to find out the high risk group of patients for burst abdomen, to determine the predictors of burst abdomen, to prevent the rate of burst abdomen & find out morbidity and mortality of burst abdomen. This cross sectional study was done among 100 cases of burst abdomen occurring in Sir Salimullah Medical College & Mitford Hospital, Dhaka and Dhaka Medical college,Dhaka during the period of July,2011 to December,2011. The patients were admitted for various surgical problems and underwent emergency laparotomy. Burst abdomen was taken into account. Another group of 100 patients who undergone emergency laparotomy but did not develop burst abdomen were also taken into account to make a comparison with the burst group. Patients who undergone elective laparotomy,paediatric age group,patients undergone exploration through mini laparotomy or transverse incision,patients with pregnancy were excluded from the study populations.Patients were assessed by history taking, examination and appropriate investigation before surgery and observed post operatively for any complication. The results were prepared on 100 patients underwent emergency laparotomy in SSMCMH & DMCH. Burst abdomen following emergency laparotomy results from multifactorial causes. The main outcome measure found significant as the risk factors of burst abdomen in this study were peritonitis (95%),anaemia (26%),malnutrition (18%), in the preoperative period; inadequate peritoneal toileting and faulty surgical techniques in the per operative period; and wound infection (62%), postoperative cough (28%), abdominal distension (22%). The result also shows that the rate of burst abdomen is still very high in SSMCMH & DMCH and most of them occur in operations done by trainee surgeons (86%) and in those patients who has 3 or more of the risk factors (44%). We hope this study will arouse awareness and concern about this problem, so that more active steps will be taken for its prevention by identifying the high risk groups. This will certainly reduce the incidence of burst abdomen. Bangladesh Med J. 2017 May; 46 (2): 38-42

Background: Blunt abdominal injury is common in trauma patients. Evaluation of patients who have sustained blunt abdominal trauma may pose a formidable problem and significant intra-abdominal injury is one of the most difficult problems faced by emergency physician and trauma surgeon in the management of trauma. Traumatic bowel injury is one of the curable traumatic conditions . An accurate and timely diagnosis and treatment give an excellent out come in most of the cases . A delay in diagnosis has been shown to be associated with significant morbidity and mortality. Objective: The purpose of the study was to evaluate the different management options and the outcome of management of bowel injury following blunt abdominal trauma. Methodology: This is a randomized clinical trial conducted over a period between July 2015 to June 2017 carried out in the Department of Casualty and General Surgery in Dhaka Medical College. Consecutive 100 patients with blunt abdominal trauma with irrespective of the age and gender were selected as study population. Results: Among the 100 cases included in the study shows outcome of the management was quite acceptable with 46% of patients having uneventful recovery. The major morbidity was related to abdominal wound and infective complications . 14% of patients had wound infection , 6% had wound dehiscence, 3% had intra-abdominal abscess, 1% had anastomotic leakage and 2 patients developed enterocutaneous fistula. Conclusion: Traumatic bowel injury is one of the commonest traumatic conditions that are encountered in the hospitals, namely in the department of Casualty surgery.It is evident from different studies that certain factors like prolonged transportation time , delay in receiving definitive surgical treatment, failure to receive early resuscitation with consequent poor hemodynamic status etc. have been associated with a poor outcome in the management of such cases. Sir Salimullah Med Coll J 2021; 29(2): 147-152