Maliha Yunus, Mumtaz Akhtar, Zeeshan Ghani, Afsheen Zafar.
Relation of pain and operative findings in acute gall bladder diseases.
Isra Med J Jan ;5(2):135-8.

OBJECTIVE: To observe whether duration of pain is a true reflector of operative findings in patients with acute gall bladder diseases. STUDY DESIGN: Observational analytical. PLACE AND DURATION: Surgical Unit-II, Pakistan Railway Hospital Rawalpindi spanning over a period of 02 years from May 2010 to May 2012. METHODOLOGY: 60 patients with acute gall bladder diseases were included through non probability convenience sampling. A proforma was designed to include clinical features, diagnostic work up, treatment plan and operative findings. Diagnostic work up included complete blood picture, liver function tests, hepatobiliary ultrasound. HIDA scan and CT scan was done if needed. Routine hematological and radiographic studies as indicated were performed. RESULTS: A total of 60 patients were studied and among them majority 83.3% (n=50) were females. In Patients with biliary colic group 41.7% (n=25), Murphy's sign was positive in 56% (n=14) and pathology on ultrasound scan was detected in 84% (n=21) of the patients. In patients with acute cholecystitis, fever 71.4% (n=25), Positive Murphy's sign 71.4% (n=25) and raised total leukocyte count 88.5% (n=31) were the commonest findings. Per operatively 68% (n=17) patients had chronically inflamed gall bladder and 16% (n=4) had acutely inflamed gall bladder among patients having symptoms of less than 12 hours duration. Acute inflammation of gall bladders commonly observed 65.7% (n=23), followed by chronically inflamed gall bladder 28.5% (n=10). CONCLUSION: Duration of pain is a strong indicator of operative findings and thus patient’s outcome.

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