Browsing by Author "Shubham Kumar Gupta"

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Minimally invasive techniques as adjuncts in low-versus high-lying retained rectal foreign bodies of autoerotic nature in young men: a tailored management algorithm with two contrasting case reports from India
(The Korean Society of Traumatology, 2024) Shubham Kumar Gupta; Vivek Kumar Katiyar; Sumit Sharma; Shashi Prakash Mishra; Satyanam Kumar Bhartiya
Retained rectal foreign bodies (RFBs) of an autoerotic nature represent an emerging and rare surgical emergency, posing a sensitive challenge for surgeons. RFBs exhibit a wide range of presentations and require varied management approaches, with the choice of treatment modality differing from case to case. Recently, minimally invasive techniques have been employed for the retrieval of RFBs. In 2021, the World Society of Emergency Surgery and the American Association for the Surgery of Trauma released guidelines on anorectal emergencies, highlighting the usefulness of these techniques as adjunctive tools for both diagnosis and ruling out associated complications. In this report, we describe two noteworthy cases of men who presented to the trauma emergency department with foreign bodies lodged in their rectums. We also highlight the potential role of minimally invasive techniques within a “step-up” approach for the management of retained RFBs. © 2024 The Korean Society of Traumatology.
Prospective validation of Bowel Injury Prediction Score for early diagnosis of surgically significant blunt bowel and mesenteric injury
(SAGE Publications Ltd, 2024) Shubham Kumar Gupta; Pramod Kumar Singh; Sumit Sharma; Sanjeev Kumar Gupta
Background: Blunt bowel and mesenteric injuries (BBMI) are frequently missed despite the widespread use of computed tomography (CT). Early diagnosis for timely management of surgically significant blunt bowel and mesenteric injuries (sBBMI) can be challenging. Several tools predictive for sBBMI have been proposed such as the “Bowel Injury Prediction Score” (BIPS) that is based on presence of abdominal tenderness, white blood cell count ≥17,000/mm3 and CT grade. The utility of this scoring system for early diagnosis of sBBMI has neither been studied in an Indian population nor prospectively validated. Methods: A single-centre prospective cohort study was conducted at a Trauma Centre in India. After screening of 1793 patients with blunt trauma abdomen who presented between 1st January 2022 and 31st August 2022 and underwent CT scan, eventually, 80 patients of age >18 years, hemodynamically stable and CT finding suspicious of BBMI were included. BIPS score was calculated. Patients were followed to evaluate the outcome. Results: The incidence of sBBMI was 3.06%. Mean age of study patients was 36.2 ± 16.5 years with male predominance (92.5%) and road traffic accidents the commonest mode of injury. Patients with BBMI were more likely to require operative intervention in the presence of abdominal tenderness at presentation (p < 0.01) and CT grade ≥4 (p < 0.01). For patients with WBC counts of ≥17,000/mm3, no statistically significant difference was noted in the need for operative intervention. BIPS ≥2 had 94.5% sensitivity, 72% specificity, 88% PPV, and 86% NPV for identifying patients with sBBMI. Conclusion: Calculation of BIPS at the time of presentation can avoid unnecessary delays in surgical management and thereby reduce overall morbidity and mortality even in an Indian setup. However, WBC counts > 17,000/mm3 were not found to be predictive of sBBMI. © The Author(s) 2023.
Reflections on Surgical Care in the Twenty-First Century—The Missing Elements in Surgical Training
(Springer, 2024) Shubham Kumar Gupta; Sanjeev Kumar Gupta; Ajay Kumar Khanna
[No abstract available]