CASE: Intrahepatic rupture of GB^-www.drkeyurbhatt.in*

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.

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

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CASE: Sub Acute intestinal obstruction --- Ileal malignancy^-www.drkeyurbhatt.in*

73 yrs female with multiple episodes of intestinal sub acute obstruction
with nausea, constipation, distension of abdomen
ESR, Montoux, TB IgG/M/A : NEGATIVE

COLONOSCOPY: Normal colon except a small polyp in ascending colon, terminal ileum up-to 5 cm normal.

CECT: Terminal ileal stricture with proximal dilated bowel loops..

 


SURGERY : Laparotomy and EXTENDED Rt hemicolectomy and terminal ileal resection for ileal mass.

Histology : Ileal carcinoid spreaded upto serosa and 2/11 nodes positive.

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Dr. Keyur Bhatt - Best Gastro Surgeon

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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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Dr. Keyur Bhatt - Best Gastro Surgeon

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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

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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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