Sunday, July 31, 2011

CASE: Gangrenous cholecystitis^-www.drkeyurbhatt.in*

24 yr male with pain and jaundice
found to have ? CBD Stone. ERC and cleared & stented
post procedure pancreatitis ...kept conservatively ...improved..but unfortunately developed gangrenous cholecystis with perforation.

SURGERY: OPEN chelecystectomy



post op biliary fistula sattleing down conservatively...

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CASE: PERSISTENT NON HEALING FECAL FISTULA^-www.drkeyurbhatt.in*

Middle aged man with intestinal obstruction
operated more than 3 months ago and resection anastomosis done for ischemic stricture..
developed controlled fecal fistula
kept conservatively...but was non healing and developing episodes of SAIO.... And out put was around 400~500 ml / day
CECT was done and taken up for surgery
SURGERY:  Segment baring fistula was resected with new ileo ileal anastomosis (side to side) and adhesilysis.




pt was discharged with normal diet on POD 6.

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CASES: 1.PERFORATED PAYOCELE 2. PERFORATED GB WITH CIRRHOSIS OF LIVER^-www.drkeyurbhatt.in*

CASE 1.OLD age women with perforated payocele of GB. Status ERC and stone clearance and stented.
was advised cholecystectomy 8 months back refuted....

ultimately landed with perforation of payocele with perforation and
SURGERY: Open cholecystectomy


CASE 2: Old age women with GB STONE and cholecystitis...kept conservatively in view of Cirrhosis of liver..
symptoms increased and was taken up for LAP cholecystectomy few months back...but considering the liver condition and intrahepatic situation of GB surgery was abandoned after placement of camera.

remained asymptomatic for another few months
now presented with sever pain in abdomen
CECT: S/O perforated GB with impacted stone in neck



SURGERY: OPEN CHOLECYSTECTOMY.




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CASE: NECROTIZING PANCREATITIS RADIOLOGICAL Drainage followed by MRPN in second month of illness^-www.drkeyurbhatt.in*

32 yrs male alcoholic
with respiratory distress, constipation,  pain , fever, vomiting in third week of NECROTIZING PANCREATITIS...

treated with minimal invasive approach...(as a first stage) with  RADIOLOGICAL Drainage of pus in lesser sac.
stabilizing him for few more weeks and than planned for necrosectomy after 6 weeks of illness.
discharged after 8 days of conservative treatment (OPN WIH ABSCESS IN THIRD WEEK) with drain now in situ...
pt on Normal diet, no fever, and soft abdomen...and residual necrosis in situ..(planned surgery after 2-3 weeks)




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CASE: MINIMAL INVASIVE (Lap assisted) PANCREATIC NECROSAECTOMY^-www.drkeyurbhatt.in*

Middle aged male with pain in necrotizing pancreatitis and 3rd week of illness
kept conservatively for one more week
CECT:




taken up for necrosectomy on day 28 of illness
SURGERY: Lap assisted retroperitoneal  pancreatic necrosectomy



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