Syed Asif Raza Kazmi, Saher Saeed, Akmal Shafique, Muhammad Mohsin Ali Dynamo, Brig Rtd Javaid Sajjad Hashmi, Sadaqat Ali Khan.
To evaluate causes of delayed presentation of Gall stone disease: a retrospective study at Punjab Rangers Teaching Hospital, Lahore.
Pak J Surg Jan ;36(4):281-5.

Background: The prevalence of gallstones is reported to range between 10% and 15% among adults. Gallstones can obstruct the cystic duct, which can cause gallbladder (GB) distension and biliary colic. Prolonged obstruction results in inflammation, infection, and even ischemia, a common condition known as acute cholecystitis (AC). In people under 50 years of age, women are three times more likely than men to develop acute cholecystytis. Repeated episodes of acute cholecystytis can result in chronic cholecystitis. Gall stones leading to Acute pancreatitis / cholangitis is also one of the known complication. Incidence of carcinoma gall bladder also increases with prolonged irritation with stones. Material and Methods: Data of 100 patients admitted with gall stone disease in surgical department of Punjab rangers teaching hospital Lahore during one year from June 2018 to June 2019, was examined. A preformed questionnaire was used to collect information about demographic variables, pre-operative symptoms, examination findings, results of investigations, operative findings and post operative outcomes. Result: In all patients, pre-operative confirmation of cholelithiasis on ultrasonography was present, with duration of symptoms ranging from 06 month to 15 years. 54% of the patients had delayed presentation due to fear of undergoing surgery and anesthesia. 40% of the patients did not have suitable access to the healthcare facilities as their husbands were posted away from home and they could not come to the hospital on their own. 06% of the patients were initially mis-diagnosed as acid peptic disease, and received symptomatic treatment in rural setting, without proper tertiary care referral. Conclusion: Measures should be taken by the Punjab Rangers department as well as healthcare regulatory authorities to promote awareness of gallstone disease, proper management of dyspepsia, timely referral, as well as provisions for proper check-up and treatment for family members of personnel.

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