Saturday, April 30, 2011

CASES: Cholecystectomy @ extreme of ages...........

CASE 1 : 

92 yrs male with perforated GB & Sepsis..
Surgery: Open Cholecystectomy and drainage
pt was discharged on POD 5.





CASE 2 : 

86 Yrs male with GALL STONES & CBD Stones..
ERCP & Removal of stone  - > lap Cholecystectomy. Discharged on POD 1.

CASE: EXTREME CASE OF chronic pancreatitis --- LPJ, HJ, GJ

37 Yrs male with intermitant pain in abdomen for 3 yrs
h/o DM for 2.5 yrs
h/o wt loss of 20 kg in 2.5 yrs
h/o gastric vomiting on and off with wt loss of 10 more kg in last 3 months....

Imaging s/o: chronic pancreatitis with stones and calcifications...
with portal vein thrombosis, lower CBD stricture, duodenal Narrowing & GOO





SURGERY: Roux en Y -  Lateral pancreatico jejunostomy, Hepatico Jejunostomy, Gastro jejunostomy.





Friday, April 29, 2011

CASE: Colo colic Intucessecption : A minimal invasive approach

62 yrs female with acute abdomen
OBSTIPATION For last 5 days

On investigation found to have Colo - colic Intucessecption near splenic flexure and large bowel obstruction.



FIRST STAGE:

Hydrostatic reduction of Intucessecption in emergency with oral contrast and saline p/r

SECOND STAGE:

Na Picosulfate oral ingestion for two consequitive days to clear bowel..

Check CT s/o total reduction of Intucessecption with empty bowel. and a small stack with the lead point of intucessptum (a lipoma)

THIRD STAGE:

Colonoscopic  removal of polyp and pt was discharged on Next day.


Tuesday, April 26, 2011

CASE: Advance case of Chronic pancreatitis with head mass and CBD obstruction

Middle aged male with chronic alcoholic pancreatitis with Dilated MPD & CBD

CECT:




SURGERY: LPJ with head coring and CDJ.


Friday, April 22, 2011

CASES: CARCINOMA RECTUM LOWER 1/3

72 Yr male with Ca lower 1/3 of rectum.
CECT:


SURGERY: Lap assisted low anterior resection with double staple anastomosis. and covering ileostomy.
 



CASE : 66 yrs male with Ca lower 1/3 of rectum. + sliding left inguinal hernia with sigmoid colon.
CECT:



SURGERY:
Open low anterior resection with double staple anastomosis and repair of sliding left inguinal hernia, & covering colostomy.



Monday, April 18, 2011

CASE: Chronic alcoholic pancreatitis -- LPJ

40 Yrs male with chronic alcoholic pancreatitis with multiple episodes of acute pancreatitis,
with 8 kg wt loss, DM.

CECT : S/O Chronic pancreaitis.

SUEGERY: LPJ





Pt discharged on POD 6.

CASE: Intrahepatic rupture of GB

89 Yrs male with high grade fever, pain, jaundice for 6 days..
Usg s/o Distended GB With perforation near fundus
CECT: Intrahepatic rupture of GB With impected stone in neck of GB Size 8 mm.
Surgery: Open cholecystectomy and lavage




Pt discharged on POD 5.