Dr. Keyur Bhatt - Gastrosurgeon

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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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 : 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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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

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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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

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)