12.12.08

Rectovaginal fistula arising as a result of prolonged labour (home conducted delivery by dai) . Easily approached from below (vaginally) and easily repaired. Patient from some outside town.

16.12.08

In a busy lap day, had the horror of seeing the so-called safety trocar (used for the umbilical camera port entry) causing intraperitoneal bleeding, shock (sudden unrecordable BP) and a big retroperitoneal haematoma seen in front of the scope on introduction of the telescope. Immediately converted and the rent in the aorta controlled with finger pressure and then sutured with 3-0 prolene. Continued to do open cholecystectomy with the courageous anesthetist’s consent. Needed 2 units of BT immediately for resuscitation and 2 more in the ward later.

 Good quick recovery afterwards, although the patient was left with a long laparotomy incision.