Thursday, December 13, 2012

case: lap splenectomy for multiple splenic abscesses.

young male with daily high spiking fever for 12 days
on work up found to have multiple splenic abscess


SURGERY: LAP. Splenectomy

patient was discharged on POD 2.

You Tube : Dr Keyur Bhatt


Elderly male with frequent lower gi bleeding and h/o severe aortic stenosis (valve area less than 10 mm) and atherosclerotic changes in descending abdominal aorta

on evaluation found to have ca recto-sigmoid junction and unfortunately patient was refuted from surgey in two major onco-surgical hospitals due to medical fitness issues..

patient was worked up and taken up for surgery

surgery: Anterior resection and primary anastomosis -
whole surgery was done in segmental epidural anaesthesia maintaining Vitals through out normal, and patient did not stayed a single day in ICU. Was started on oral diet by day 3 and discharged on day 6 uneventfully,

Bx: T3N0 moderatedly differentiated adenocarcinoma of rectum.

You Tube : Dr Keyur Bhatt

Wednesday, December 12, 2012

CASE: Acute mesenteric ischemia due to acute block in SMA

Middle aged male with pain abdomen for last 3-4 days acute in onset..central abdominal pain
with vomiting ...past history of CHD and coronary stenting done before 3 yrs

CECT  was done and was s/o acute sma block with thrombosis and proximal bowel gangrene and distal bowel ischemia...along with that air pockets in all lobes of liver..

taken up for surgery:

DAY 1: laparotomy and Superior Mesenteric Aartery exploration and thrombectomy and closure

Day 2: Re -exploration, proximal bowel resection anastomosis ..lavage and drainage.

patient was on inotrops and venti support for 7 days and was gradually improved  and started on oral diet and discharged on day 12.

You Tube : Dr Keyur Bhatt

CASE:myofibroblastic tumor from colon - excision with wedge resection

Young male with mass in RHC region for 3 months
No significant GI or other symptoms
progressively increasing in size

surgery: wide local excision with Gastric sleeve resection, pancreatic sleeve in tail region and colonic (transverse colon-segmental involvement) resection and anastomosis

patient was discharged on POD6. Uneventfully
Bx: IHC  : s/o myofibroblastic tumor with low mitotic index (1 mitotic /50 fields )

You Tube : Dr Keyur Bhatt