Outcome of Obstructing vs Nonobstructing Colorectal Carcinomas: Comparative Study at Tertiary Care Hospital in Kashmir.

Background: Colorectal cancer (CRC) is the commonly diagnosed malignancy presenting either in obstruction or without obstruction. Bowel obstruction (BO) is usually a complication of advanced cancer, significantly reducing the quality of life. We aimed to study the outcomes of these obstructed colorectal cancers requiring emergency intervention and compare it with nonobstructed cancers. Materials and methods: In our observational comparative study, patients were divided into groups on basis of their presentation and site of lesion: nonobstructing colon group/obstructing colon group nonobstructing rectum group/obstructing rectum group. Results: A total of 232 patients with known modes of presentation between 2015 and 2018 were included; 144 colonic, 88 rectal carcinomas with 71 being completely obstructive ones. Our study showed higher recurrence in obstructive groups with local recurrence being more common. The median interval for recurrence was early in obstructive group (p < 0.001*). The overall 5-year survival rates were better in Nonobstructing colon group, (p = -0.046* in OR vs NOR) (p = -0.031* in OC vs NOC). 5-year disease-free survival rates statistically insignificant (p = 0.203 in NOC and OC groups), (p = 0.307 in NOR and OR groups). Immediate post-op, complications except for SSI, there was no significant difference between the two groups. Our study showed higher proportion of R0 resection in NOC groups as compared with obstructive groups (p = 0.021* in in OC vs NOC and p = 0.037* in OR vs NOR) with better lymph node retrieval in NOC groups. Conclusion: On comparing outcome of patients who had completed multi-modal therapy in both groups, there was significantly better outcome for patients who have presented without obstruction. How to cite this article: Ul Haq MF, Bhat GA, Wani MA, et al. Outcome of Obstructing vs Nonobstructing Colorectal Carcinomas: Comparative Study at Tertiary Care Hospital in Kashmir. Euroasian J Hepato-Gastroenterol 2024;14(1):75-80.

A Study of Predictors of Failure of Nonoperative Management of Ileocolic Intussusception in Children.

Background: Surgery remains the mainstay in treating intussusception in developing nations. A correspondingly high bowel resection rate exists despite a shift to nonoperative reduction in high-income countries. We aimed to study the clinical profile of the patients with intussusception presenting to our hospital and to assess the clinical and radiological predictors of success or failure of nonoperative management of intussusception. Materials and methods: This prospective study was conducted in the Department of Pediatric Surgery over a period of 3 years and included a total of 118 patients who presenting to our emergency division with features suggestive of intussusception and were managed accordingly either with hydrostatic reduction or by surgical intervention. Results: We observed that the majority of the patients were males (65.5%). The mean age was 13.54 months. Intermittent pain was the most common symptom. Both pain and vomiting did not affect the outcome. Lab parameters like raised total leukocyte counts (TLC), C-reactive protein (CRP) and lactate levels were significantly associated with failure of hydrostatic reduction. Patients with air fluid levels on X-ray were more likely to end up in surgery. Ultrasound findings of bowel wall edema, aperistaltic gut loops and a pathological lead point was associated with failure of hydrostatic reduction as well. The overall success rate of hydrostatic reduction was 85.5%. Conclusion: Hydrostatic reduction of intussusception is a safe and effective method of management of intussusception whenever indicated. Factors that might reduce the chance of its success include continuous pain, irritability, tenderness, deranged lab parameters like TLC, CRP and lactate levels, air fluid levels on X-ray, bowel wall edema, aperistalsis and the presence of a lead point. How to cite this article: Shah JY, Banday I, Hamdani HZ, et al. A Study of Predictors of Failure of Nonoperative Management of Ileocolic Intussusception in Children. Euroasian J Hepato-Gastroenterol 2024;14(1):81-85.

Early Postoperative Small Bowel Obstruction after Colorectal Surgery: Incidence and Exploratory Analysis of Potential Risk Factors.

Background: Early postoperative small bowel obstruction (EPSBO) is a common complication following colorectal surgery, which can significantly impact patient outcomes. This study aimed to investigate the incidence of EPSBO and identify potential risk factors among patients who underwent colorectal surgery. Methods: A descriptive study was conducted on a cohort of 100 patients who underwent colorectal surgery at a tertiary center at SKIMS, Srinagar, Jammu & Kashmir, India. Descriptive, bivariate, and predictive screening analyses were performed to examine patient characteristics, assess association between different relevant variables and EPSBO, and identify significant predictors, respectively. Results: Our study included a total of 100 patients, with a mean age of 50.39 years. Postsurgery, 11% of the individuals in the cohort developed EPSBO. Early postoperative small bowel obstruction developed around 4.30 days after surgery, and radiographic data revealed dilated gut loops in 72.70% of EPSBO cases. Bivariate analysis revealed significant association between EPSBO and variables such as previously operated, medical comorbidities, smoking status, anemia, neoadjuvant chemoradiotherapy (NACRT), bowel preparation, operative procedure, surgery duration, and type of anastomosis (p < 0.05). History of previous bowel habits, previously operated, perioperative bowel preparation, and blood transfusion were identified as the most influential predictors of EPSBO in the predictive screening study. Conclusion: This study provides insights into the incidence of EPSBO and its potential risk factors for postcolorectal surgery among patients. The findings emphasize the need to take the patient's history of past bowel habits and other factors into account when determining the risk of EPSBO. Future studies should go deeper into these correlations and consider treatments to reduce the occurrence of EPSBO in this patient population. How to cite this article: Ahmad B, Ul Hag MF, Shah MA, et al. Early Postoperative Small Bowel Obstruction after Colorectal Surgery: Incidence and Exploratory Analysis of Potential Risk Factors. Euroasian J Hepato-Gastroenterol 2024;14(1):70-74.

Jejunogastric Intussusception: A Rare Case Report Study.

Jejunogastric intussusception (JGI) is a rare, potentially fatal complication of gastrojejunostomy following any gastric resection or gastric bypass surgery. Very less no of cases have been reported to date in the literature, with a very low incidence of <0.1%. Early recognition of JGI followed by prompt intervention is necessary to avoid any serious complications of gut gangrene or even possible death. It carries a mortality rate of approx. 10% of patients subjected to early intervention within 24 hours as compared to 50% in cases where surgery was delayed for more than 48 hours. The usual presenting complaints include a triad of palpable epigastric mass, hematemesis, and epigastric pain with only 50% of patients having this classical presentation. We here, report a middle-aged male with JGI which was diagnosed and managed at our center with emergency surgical intervention. How to cite this article: Haq MFU, Wagay BA, Malik AA, et al. Jejunogastric Intussusception: A Rare Case Report Study. Euroasian J Hepato-Gastroenterol 2023;13(2):163-165.