Sunday, October 23, 2011

CASE: Mesentric tumor excision^-www.drkeyurbhatt.in*

Middle aged women with h/o corossive gastric outlet obstruction and GJ done 15 yrs back, operated for PILES - MIPH 2 yrs back for bleeding PR.

c/o pain in central abdomen,
USG : S/O Soft tissue tumor near neck of pancreas behind stomach

CECT:


EUS : FNAC / BX : S/O malignant tumor.
SURGERY: EXCISION OF TUMOR.









pt was discharged on POD 5, with normal DIET.  FINAL HPE with IHC awaited.

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Dr. Keyur Bhatt - Best Gastro Surgeon

Dr. Keyur Bhatt- Best GI Surgeon

Dr. Keyur Bhatt - Best Gastro Surgeon

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

                                   Dr Keyur Bhatt- Best GI Surgeon     

 

 

CASE: Acute PV & SMV thrombosis + jejunal ischemia - staged approach for surgery^-www.drkeyurbhatt.in*

Middle aged male with c/o severe pain in abdomen, nausea, vomiting & constipation, rise TLC
CECT S/o: acute Portal, SMV, Splenic vein thrombosis with proximal jejunal ischemia/gangrene




PLAN:  Managed conservatively with Heparin and Anticoagulants --> gradually started on diet and discharged with close follow up. as suspected stricture in jejunum in coming days.

Readmitted with vomiting after 6 weeks, no pain, rest all Investigations normal.
CECT: S/o : Completely recanalised portal and SM vein, with stricture in proximal jejunum and dilated proximal bowels


PLAN: Taken up for surgery and resection with primary anastomosis of strictured segment. discharged on POD 6, With normal diet. 

Acute mesenteric venous gangrene/ischemia can be managed conservatively provided with normal arterial flow and patient being kept in ICU with proper monitoring, and later as they develop stricture can be managed with single stage surgery, avoiding stoma formation in case of management of gangrenous bowel, and doubtfull viability of bowel with thrombosed veins.

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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 - Dr Keyur Bhatt - Best Gastro Surgeon

                                   Dr Keyur Bhatt- Best GI Surgeon     

 

 

CASE: LAP Haller's myotomy & anterior fundal wrap (achalasia with hiatus hernia)^-www.drkeyurbhatt.in*

Middle aged female with progressive painless dysphagia
on investigation found to have achalasia cardia and hiatus hernia as well with 8 kg wt loss.
UGIE: no e/o malignancy

SURGERY: Lap haller's myotomy & anterior fundal wrap


Pt was discharged next day.
had 4 kg wt gain by the time to stitch removal only..www.gisurgerysurat.com

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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 - Dr Keyur Bhatt - Best Gastro Surgeon

                                   Dr Keyur Bhatt- Best GI Surgeon     

 

 


Sunday, September 25, 2011

CASE: Trans gastric necrosectomy (acute alcoholic necrotizing pancreatitis)^-www.drkeyurbhatt.in*

28 yrs male, chronic alcoholic with severe necrotizing pancreatitis
day 36 of illness with fever, agonizing pain, persistent vomiting

CECT: Infected pancreatic necrosis
 

SURGERY: Trans gastric pancreatic necrosectomy







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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 - Dr Keyur Bhatt - Best Gastro Surgeon

                                   Dr Keyur Bhatt- Best GI Surgeon     

 

 

CASE: Chronic alcoholic pancreatitis with head mass - LPJ^-www.drkeyurbhatt.in*

34 Yrs male with chronic alcoholic pancreatitis with head mass
8 kg wt loss, severe intractable pain in abdomen with back radiation,

SURGERY: LPJ With head coring.




Discharged on POD 7.

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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 - Dr Keyur Bhatt - Best Gastro Surgeon

                                   Dr Keyur Bhatt- Best GI Surgeon