Archive for December 2009
15.12.09
La chole: ward worker, obese hypertensive lady 55 yr old.
Lap chole: 65 F admitted last week with gallstone pancreatitis which had resolved by now. Readmitted 25.12.09 with severe abdominal pain.
18.12.09
Lap repair of paraumbilical hernia.
Lap varicocelectomy 20 M.
19.12.09
Irreducible direct left inguinal hernia which had sigmoid colon nearly strangulated. 60M. Cord divided and mesh repair done.
20.12.09
(winter vacation 20.12.09 to 2.1.10).
TAHbSOP with sacrocolpopexy and mesh fixation of rectum to sacrum too for rectal prolapse. 65F from the hills with uterine and rectal prolpase. Had postop SBO due to adhesions for which laparotomy and adhesiolysis had to be done.
22.12.09
TLH for big fibroids made handling of uterus difficult. Took nearly 3 hours.
23.12.09
lap appy 25M, easy.
TEP for direct left inguinal hernia. 25M. Neat despite pneumoperitoneum and despited avulsion of inferior vascular pedicle which was simply coagulated and divided.
24.12.09
Laparotomy for suspected appendicitis which turned out to be biliary peritonitis in a 6 years old male child. The cause of bile leak traced to CBD the anterior wall of which had necrosed (cause??)and oozing bile. Repaired with cystic duct flap over a T rube.
28.12.09
TLH for huge uterus due to huge fibroids reaching upto above the umbilicus. Took nearly 5 hours. The uterus had to be cut into 4 pieces to be removed per vagina (morcellator not available).
28 and 29 november
Went to Kasauli with Dr Hardip Singh Mann and joined other classfellows of the 75GOMCO batch for a get-together. Stayed overnight and came back next day. Met old friends – dr Dharam Pal, Dr Tarsem Rattu, Dr Ravi Dawra, Dr Brij Kishore, Dr Bhucho (Keshav Garg), Dr Zora Singh, Dr Sohan Singh, Dr Gursharan Malhi, Dr Surinder Gupta, Dr Harjit Singh (braather), and many more.
30.11.09
Wide local excision (a near mastectomy) of an indeterminate mass despite 2 FNACs and mammography in an 85 year old female (an ex health worker – ANM). HPE- IDC. Started on tamoxifen.
A potential disaster averted just in time – lap chole in a 65 year old male, very difficult procedure. Liver firmly stuck to abdominal wall and absolutely immobile. Thick walled gall bladder with a very difficult grasp. A very easily dissected CHD, misidentified as CD, was clipped and about to be divided, when better sense prevailed, clips removed and a further dissection revealed a very short and thick cystic duct which was ligated with extracoporeally tied vicryl. Stormy postoperative period with abdominal distension and vomiting, the NG tube poured greenish output for a couple of days and then everything settled!! Could never tell what happened!!. A postoperative US scan and LFTs were normal.
1.12.09
Units of surgery department reshuffled after retirement of Dr Karam Singh. Mine will be 4the now, ward 3.
4.12.09
Microdochectomy for a single duct discharge from left nipple. 30 F, a principal of a school. Biopsy showed a well-formed papilloma.
9.12.09
Seminar on early detection of breast cancer.
11.12.09
A recurred swelling left forearm near the lower end of ulna. Presumably lipoma, turned out to be a swelling arising out of the tendon sheath of the extensor of the little finger, the ulnar artery pulsating close by. Excised under GA, preserving the tendon.
Dr Mohinder Singh's blog 