Dr Mohinder Singh's blog

16.9.2006

Apparently easy case in a 50 years old woman. Actually very difficult due to unexpected empyema;  the pus was aspirated. The grasp at the neck was difficult; broke a grasper. The CD was very short;  the wall of the gallbladder was very adherent to the liver bed; the liver bled badly to cause hypotension; the liver sinus had to be sutured when it could not be controlled by cautery. The port was enlarged to remove the gallbladder and the big hard stone (2 cm) separately in a bag ( the stone could not be grasped).

Another lap chole in a 50 years old female was not so difficult ; but the big stone in neck when held in spoon forceps broke the spoon forceps; the port had to be enlarged to remove the gall bladder.

12.11.06

A parathyroid adenoma  of the left lower parathyroid gland (4X2 cm) was excised through a lower neck transverse incision. The patient had been referred from urology when they investigated her for large bilateral staghorn kidney stones. Earlier the patient had presented to the orthopedics department for backache and generalized weakness. They referred her to urology when they found the bilateral kidney stones.

2.10.06 (Dussehra holiday)

An emergency laparotomy (on a holiday) for obstructing colon cancer. The patient was a staff nurse Paramjit Kaur Hundal 45 years old admitted with large bowel obstruction and bleeding per rectum. Family history of large bowel cancer was present. Colonoscopy showed a lesion at 60 cm, and CT scan showed a big growth at splenic flexure. Biopsy (colonoscopic)  – adenocarcinoma WD.

An extended right hemicolectomy was performed. Specimen showed a big tumor near splenic flexure and lots of ulcerations and nodules in an area of angry-looking field change proximal to the tumor.

Remains well till last seen (2015 November).