Archive for April 2008
trichilemmal cyst and a parotid
Posted on: April 25, 2008
1. TAH for DUB – patient did not want gynae to do the operation!
2. breast fibroadenoma – sonia 16F d/o kammo. excised under local
3. swelling on back, diagnosed as lipoma. 35F. excised under local. photo attached. the opened up cyst shows some hair too besides the pultaceous material, so thought ot be a dermoid, but the site (back) seems to be strange.
histopathology – trichilemmal cyst.
4. 40M from chupki with a parotid swelling and facial N palsy for 2 months. FNA – benign pleomorphic adenoma. the tumour densely adherent to the trunk and its bifurcation (cause of palsy) sharply excised here. thereafter the branches of the nerve were intact.
22.4.08
1. diagnostic laparoscopy: 45M fed up with no diagnosis being made for non-specific abdominal pain. the urologist had diagnosed a small ureteric stone which was allegedly removed (no record available). pain still continuing. At laparoscopy, had adhesions in both iliac fossae with abdominal wall; these were easily divided. Appendicectomy too carried out.
2. a quick, easy and neat lap chole
3. a submuscular lipoma left lower chest wall excised under local anaesthesia 25M
4. an extended right hemicolectomy for big tumor transverse colon. Young 25 M with family history of cancer, neglecting his symptoms for 2 years; now reported with bleeding per rectum and at Hb level of 4G%. had 5 blood transfusions.
ascites small amount present. liver clear. but the tumour was locally adherent with omentum and nearly encroaching upon the greater curve of the stomach. was also adherent with the very first part of jejunum being stuck in the DJ flexure. Palliative resection carried out with ileotransverse anastomosis.
nephrectomy
Posted on: April 14, 2008
13.4.08
60 M, diagnosed with tumor lower pole left kidney when US and CT were done for pain in the flank. Hypertensive patient with a previously scarred abdomen (operation details not known) was taken up under SA and in kidney position for the nephrectomy which was easy.
NCASI conference at Rohtak
Posted on: April 4, 2008
went to Rohtak
for the conference with dr as grover, dr jagbir singh, dr sukhpreet singh, dr pawandeep singh dang
1. Small umbilical hernia PUH, Dr Karnail Singh’s pt. 55 M. Mesh repair.
2. IGTN both sides of right big toe. Yadwinder Singh 20 M from bakrana
3. chole and CBDE open. 60F diabetic with jaundice due to CBD stones. c/o hardam OT employee. ERCP scope in GMC Chandigarh out of order, so decided to go open. Right decision in the end; big stone in neck ( mucocele) as well as 5 big stones in common duct. All extracted. Very wide cystic duct. Fogarty tried in the end to confirm clearance. T-tube put in.
4. Presumably simple parotidectomy became very difficult. 60 M Dr Karnail Singh’s patient. All tumour under the nerve trunk and its branches. Very big bossellated tumour, extending up to the right parapharyngeal space and right submandibular area. difficult procedure. The trunk of the facial N was longer than expected (possibly had become longer due to chronic stretching over the big tumour); its upper division was saved nicely but a branch from the lower division was avulsed.
4. Presumably simple parotidectomy became very difficult. 60 M Dr Karnail Singh’s patient. All tumour under the nerve trunk and its branches. Very big bossellated tumour, extending up to the right parapharyngeal space and right submandibular area. difficult procedure. The trunk of the facial N was longer than expected (possibly had become longer due to chronic stretching over the big tumour); its upper division was saved nicely but a branch from the lower division was avulsed.
Dr Mohinder Singh's blog 