Tuesday, March 29, 2011

CASE: DUODENO JEJUNAL INTUSSUSCEPTION^-www.drkeyurbhatt.in*

19 YR girl with acute abdominal pain and persistent vomiting
USG: S/o dilated stomach and duodenum
CECT S/O : Duodeno Jejunal Intussusception


 


SURGERY: Lap assisted reduction of Intussusception and resection & anastomosis of polyp baring segment of proximal jejunum.


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Friday, March 18, 2011

CASE: NCPF + hypersplenism --> PSRS (Proxymal Spleno Renal Shunt)^-www.drkeyurbhatt.in*

35 yrs female with 5-6 yrs history of PORTAL hypertension (NCPF) non cirrhotic portal fibrosis
UGIE: S/O Grade 3 multiple columns of varices in GE junction, PGP+, IGV+.
DOPPLER : S/O Portal vein diameter 2 cm . splenic vein 12 mm. with multiple colaterals.& massive splenomegaly.Liver slightly bright in echotexture, left renal vein normal.

Clinically : pallor ++ with spleen reaching in RIF.

LFT : Normal
TLC : 2000./ cmm        Hb : 6 gm / dl
PLATELATE : 22,000 / cmm

SURGERY: SPLENECTOMY AND PROXIMAL SPLENO RENAL SHUNT.





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CASE : Complete intestinal malrotation with Cecal Volvulus^-www.drkeyurbhatt.in*

38 yrs male
pain in abdomen for 3 days with differential abdominal distension more in LIF
Associated with constipation and nausea
p/h/o open appendectomy 15 yrs back from RIF incision..

USG : S/O volvulus of sigmoid colon
X RAY: S/O volvulus of colon arising from pelvis with few more air fluid levels
suspected diagnosis: Sigmoid Volvulus..

Sigmoidoscopy: normal...

CECT : Large bowel obstruction with ? p/o  Malrotation with kink midway ? cecal volvulus..with diameter of colon . >10 cm.. and dilated proximal bowel loops..



  



SURGERY:  (Exploratory Laparotomy): Derotation, untwisting and division of a LAD Band and repositioning of cecum in left iliac fossa (as this is a case of complete intestinal malrotation type 3) and decompression.















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Thursday, March 10, 2011

CASE: CYSTO DUODENOSTOMY^-www.drkeyurbhatt.in*

21 Yr girl with h/o acute Idiopathic  pancreatitis 6 mths back
resolved with development of pseudocyst.

Significantly increasing in size and causing gastric outlet obstruction and visible lump..

CECT:




SURGERY: Cysto duodenostomy (the most Dependant portion of cyst)


Pt is now on oral diet and ready for discharge..

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Tuesday, March 8, 2011

CASE: ACUTE MESENTERIC VENOUS THROMBOSIS & BOWEL GANGRENE^-www.drkeyurbhatt.in*

28 yrs male with pain in abdomen for 3 days
distension, nausea, Melena
Rising TLC and agony

CECT:

SURGERY: Laparotomy and resection of gangrenous segment of jejunum (as stated in scan with venous thrombosis) and stoma.
(1.5 liters of toxic fluid and gangrenous distal jejunum)





Pt about to go home... with distal mucus fistula feeding....

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