Primary Cecal Pathologies Presenting as Acute Abdomen

NCT03262025 | Completed

• 1 other identifier: CecalJNMC
• Study Type: observational
• Target: 43
• Locations: 0 countries
• Sites: N/A

Brief Summary

Background: The importance of cecal pathologies lie in the fact that being the first part of large intestine, any disease involving the cecum affects overall functioning of the large bowel. Primary cecal pathologies presenting as acute abdomen have not been described in any previous study in terms of presentation, management and outcome. Objectives: The objective of this study was to identify the reported causes of primary cecal pathologies presenting as acute abdomen and the various causes presenting in Indian setting, to discuss morbidity and mortality associated with cecal pathologies and to critically analyse the various management modalities employed in emergency setting.

Conditions

Acute Abdomen; Emergency Surgery; Laparotomy; Amoebic Colitis; Diverticulitis of Caecum; Typhlitis

Keywords

Primary cecal pathology; Emergency laparotomy; Ruptured liver abscess; Right hemicolectomy; Conservative colonic resection; Fulminant amoebic colitis; Ileocecal resection; Ileoascending anastomosis; Ileotransverse anastomosis; Cecal diverticulitis; Amoebic typhilitis; Idiopathic typhilitis

Outcome Measures

Primary Outcomes (1)

• Pattern of primary cecal pathology in Indian setting

  The objective of this study was to identify the reported causes of cecal pathology presenting as acute abdomen in medical literature and the various causes presenting in Indian setting, to identify the pattern of common pathologies in Indian setup, to discuss morbidity and mortality associated with cecal pathologies and to critically analyse the various management modalities commonly employed for cecal pathologies presenting as acute abdomen.

  10 years

Study Arms (4)

Operated patients who survived

Patients who were discharged in index hospital admission after operative intervention

Procedure: Operated

Operated patients who expired

Patients who expired in index hospital admission after operative intervention

Procedure: Operated

Non-operated patients who survived

Patients who were discharged in index hospital admission after being managed conservatively

Non-operated patients who expired

Patients who expired in index hospital admission after being managed conservatively

Interventions

Operated PROCEDURE

Patients were either managed conservatively or underwent emergency laparotomy

Operated patients who expired; Operated patients who survived

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All adult patients presenting in the emergency department with acute abdomen were included in study in whom cecal pathology as the cause of acute abdomen was suspected clinically and/or on imaging and further confirmed per-operatively and/or on histopathological examination (HPE) or on imaging.

You may qualify if:

• All adult patients presenting in emergency department with acute abdomen were included in study in whom cecal pathology as the cause of acute abdomen was suspected clinically and/or on imaging and further confirmed per-operatively and/or on histopathological examination (HPE) or on imaging. Patients identified with primarily a cecal pathology who had acute pain abdomen as the initial symptom but who didn't presented immediately due to various reasons were also included in the study as it is a well-documented fact that patients in developing countries like India, especially those who live in rural areas or who are illiterate often resort to indigenous methods of treatment or take symptomatic treatment from local practitioners before presenting to a tertiary centre for definitive treatment. Also, only those patients who were operated within 24 hours of index admission in the emergency operation theatre (EOT) by a registrar or faculty member after initial resuscitation were included in the study.

You may not qualify if:

• Patients with sub-acute, intermittent or chronic pain; when predominant symptoms were attributable to some other cause even with concomitant presence of a cecal pathology; when predominant pathology was not cecal and patients with cecal pathology operated as an elective case were excluded from this study. Thus patients diagnosed to be having appendiceal stump blowout, perforation of base of appendix, ileocecal tuberculosis or intussusception were not included.

Sponsors & Collaborators

• Jawaharlal Nehru Medical College: lead

MeSH Terms

Conditions

Abdomen, Acute; Dysentery, Amebic; Typhlitis

Condition Hierarchy (Ancestors)

Abdominal Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Signs and Symptoms, Digestive; Intestinal Diseases, Parasitic; Parasitic Diseases; Infections; Amebiasis; Protozoan Infections; Dysentery; Gastroenteritis; Gastrointestinal Diseases; Digestive System Diseases; Intestinal Diseases; Intraabdominal Infections; Enterocolitis, Neutropenic; Enterocolitis; Cecal Diseases

Study Officials

• Kaushal D Singh, MS Surgery

  Jawaharlal Nehru Medical College, Aligarh

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 23, 2017
• First Posted: August 25, 2017
• Study Start: January 1, 2016
• Primary Completion: May 31, 2017
• Study Completion: July 15, 2017
• Last Updated: August 25, 2017

Record last verified: 2017-08