Archive for January 2007
26.1.07
Marriage attended at Kohinoor marriage palace Rajpura road.
25.1.07
Bascom operation for pilonidal sinus – first time; The patient was an intern.
22.1.07
Mehar Singh (worker at Principal Dr Kiranjit Kaur’s farm), a 50 year old male, had perforation (typhoid ileal perforation) peritonitis 4 months back and had the perforation closed. This leaked and then an ileostomy was made. This was now closed.
2 easy lap choles
Posted on: January 15, 2007
15.1.07
1. 35 years old female with an easy gall bladder.
2. 35 years old female with a gall bladder with with a short cystic duct.
11.1.07
Lipoma oral cavity diagnosed as mucus cyst.
Called to help at nephrectomy for big upper pole renal cancer adherent with the liver. The exposure was inadequate.. Improved exposure led to an easy nephrectomy.
Ileocecal tuberculosis misdiagnosed as appendicitis, and a fallacy of perception in lap chole
Posted on: January 8, 2007
7.1.2007
A fallacy of perception at lap chole occurred in a 35 years old talkative lady (relative of daughter-in-law of dr Modi). The long narrow neck of gallbladder was perceived as the cystic duct and thus the dissection remained at a higher level leading to confusions in anatomy, and the cystic artery not being found. A further lower dissection revealed the cystic duct at lower level, with the artery behind it in dense adhesions in the Calot’s triangle.
25 years old male from Jagraon was diagnosed as appendicitis and appendicectomy done at civil hospital Jagraon. Biopsy of appendix was reported as tuberculosis. Was started on antituberculous therapy. Had taken these drugs for 2 months, but continued to have attacks of intestinal obstruction.
At operation, the caecum was found to be contracted and and terminal ileum tightly strictured 2 strictures proximal to cecum along with other multiple strictures proximally. This 15 cm length of terminal ileum with strictures and cecum were excised and EEA done.
4.1.07
OP Sharma a 55 years old obese male with a French-cut beard presented with features of intestinal obstruction. Had a laparotomy previously in 1993 (Dr Mahesh Gupta) for abdominal pain at which probably (no records available) adhesiolysis was done and thereafter the patient was started on ATT (antitubercular therapy) initially for 6 months and then again for one and half years. The symptoms persisted. Dr Pramod, the gastroenterologist, then got a BMFT done. This revealed strictures in the small intestine.
At laparotomy now, dense adhesions were encountered in the RIF. These were lysed. A band obstructing the midileum was divided. And then 3 strictures in the proximal ileum in a segment of 6 inches were resected and an EEA done.
Dr Mohinder Singh's blog 