Friday, January 28, 2011

CASE: TRAUMATIC TRANSECTION OF D-J FLEXURE^-www.drkeyurbhatt.in*

18 yr male with blunt trauma head and abdomen
with Normal CECT Brain.
Pneumoperitoneum and bowel perforation on CECT abdomen.

on exploration almost complete transaction of DJ flexure was found....with peritonitits...

after thorough lavage both the ends of transaction were trimmed 1.5 cm and Single layer Extra Mucosal Interrupted anastomosis done....RT placed in D-2.. and A feeding Jejuonostomy was done...with drainage...

Pt is doing well on POD 6..Today.. tolerating sips orally and Jejuonostomy feeding as well...Out of Sepsis...

DISCHARGED TODAY WITH NORMAL DIET..AND HEALTHY WOUND..27.1.11.

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Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon

Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon - Dr Keyur Bhatt - Best Gastro Surgeon

Dr Keyur Bhatt- Best GI Surgeon

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Thursday, January 20, 2011

CASE: CDC TYPE 1B^-www.drkeyurbhatt.in*

22 yrs female with colicky pain for 2 yrs..
USG s/o CDC
MRI : S/O CDC TYPE 1 B

Underwent CDC excision and RYHJ

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www.drkeyurbhatt.in/

www.sidshospital.com

Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon

Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon - Dr Keyur Bhatt - Best Gastro Surgeon

Dr Keyur Bhatt- Best GI Surgeon

Wednesday, January 19, 2011

CASE : BASICS ARE ALWAYS BASICS^-www.drkeyurbhatt.in*

A pt with acute abdominal recurrent pain in LHC region, and centeral umbilical region...with episodic vomiting..in last 15 days got admitted with 3 consultants including a surgeon...but not relieved of pain/vomiting...

CECT was even done ....NORMAL...finally I GOT ref. for acute unresolved abdominal pain....

& ...OH ...............................it was b/l inguinal enterocele (reducible)with dragging pain stretch on mesentry. leading to central abdominal pain (stretch on mesentry) and vomiting...DIAGNOSTIC LAP AND B/L HERNIOPLASTY ( LAP ) DONE AND PT RELIEVED OF EVERYTHING.....

WE should never omit inguinal examination for abdomen....

www.gisurgerysurat.com/

www.drkeyurbhatt.in/

www.sidshospital.com

Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon

Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon - Dr Keyur Bhatt - Best Gastro Surgeon

Dr Keyur Bhatt- Best GI Surgeon

CASE: clinical judgement and Radiology both can miss lead but pathological diagnosis is always confirmatory^-www.drkeyurbhatt.in*

15 yr male pt with vague abdominal pain and low grade fever..low appetite and diarrhoea..
mild abdominal distension, no tenderness free fluid +
pt roaming around..taking oral diet..passing stool...but constant discomfort

USG: S/O Loculated free fluid and matted bowels p/o Koch's
CECT: Similar findings with dilated appendix with Fecolith in appendix..p/o Koch's
ADA : 150 (normal up to 60)

so by this all means Koch's was almost certain....

but the surprising thing was TLC: 22,000...So fluid (turbid) was aspirated and sent for exm. and showed frank pus (fluid count >75,000 and protein > 3.5: s/o exudate and pus)TLC Elevated to 29,000 (still pt walking, no fever, passing stool, no vomiting) but decision of exploration was taken with consensus of GI Physician, Physician, And Me. and what we found.....1.5 liter of pus with 1 kidney tray full of pus flakes....

sometimes even clinical judgement and Radiology both can miss lead but pathological diagnosis is always confirmatory....(fluid examination, TLC)...and can save lives....

www.gisurgerysurat.com/

www.drkeyurbhatt.in/

www.sidshospital.com

Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon

Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon - Dr Keyur Bhatt - Best Gastro Surgeon

Dr Keyur Bhatt- Best GI Surgeon