CASES: DISTATL PANCREATECTOMIES^-www.drkeyurbhatt.in*

1. CASE: young male with chronic calcific pancreatitis with mass in distal body of pancreas..with recurrent episodes of acute pancreatitis...

on evaluation found to have multiple stones in head of pancreas with dilated duct 12mm and inhomogenous mass and distorted pancreas in distal tail with multiple dilated side branching..

SURGERY: Distal pancreatectomy  with splenectomy and PANCREATICO JEJUNOSTOMY

Bx: benign chronic inflamation of pancreas..pt was discharged on day 10.

case 2: 13 yrs old girl with h/o blunt trauma abdomen..

detected to have totally transected pancreas at body tail junction

presented within 12 hrs of injury...was explained the need of surgical intervention..unfortunately..did not got ready...but presented again 48 hrs later with distension and vomiting, tachycardia, hypotension...

fortunately spleen preserving distal pancreatectomy was done on day 3 of trauma

IMAGES: 

patient discharged home uneventfully  on day 6.

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CAS: RE DO RYHJ -Status stricture RYHJ FOR BDI^-www.drkeyurbhatt.in*

Young female with h/o BDI during lap chole 6 yrs back and intra op HJ Was done

h/o recurrent cholangitis for last 1.5 yrs 

on evaluation found to have dilated IHBRD with strictured anastomosis of HJ

MRCP:

SURGERY: RE DO RYHJ (3.2 CM anastomosis)

patient was discharged on POD 5 without any complications..

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CASES: PANCREATIC NECROSECTOMIES^-www.drkeyurbhatt.in*

case 1:  acute necrotizing pancreatitis with localized necrosis in lesser sac day 38.. with air foci ( infected )  and majority component in liquid form..

taken up for endoscopic transgastric necroesctomy and was done successfully ( more than 2 liter of pus was drained ) and pt was shifted to icu for observation
for day or so pt improved clinically but again in 3 days had a similar distension, respiratory distress, tachycardia..and rise in count

CECT was done and was s/o again collection  ( gross) almost similar to pre endoscopy and free intra peritoneal gas as well..along with more necrotic solid area

was timely taken up for open necrosectomy...and discharged with left sided drain in situ on day 12..with oral diet..


CASE 2: Young female with ideopathic acute necrotizing pancreatitis with severe infected necrosis..
with worsining G/C and daily persistant spikes of fever , respiratory distress and distension, low out put on DAY 29 Of illness was taken up for open necrosectomy

had very severe wound infection ...treated with dressing and secondary suturing...doing well now all drains out by now..patient at home and taking normal diet, ambulant.

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CASE: CA SIGMOID With LGI bleed^-www.drkeyurbhatt.in*

elderly (86 yrs) female with LGI Bleed for last one year
on evaluation found to have CA SIGMOID.

PLANNED FOR ANTERIOR RESECTION AND primary anastomosis..

successfully discharged with normal diet on day 7.
 BX. : S/O adenocarcinoma with all nodes negative and T3 lesion.. all margins free

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CASE: CA COLON With adjacent liver infiltration^-www.drkeyurbhatt.in*

middle aged male with constipation and anemia, CABG was done six months ago
evaluated and worked up ..found to have CA hepatic flexure with adjacent liver infiltration

CECT:

SURGERY: Extended rt hemicolectomy and in toto segment 6 resection of liver

all margins clear..adeno ca with free liver margin.... 6/12 lymph nodes positive..

pt schedule for chemotherapy

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