Dr Mohinder Singh's blog

17.8.19

A routine lap chole in a 55 years old female turned out to be unexpedtedly difficult, resulting in considerable bleeding from the liver bed. This was controlled with cautery and pressure with gauze, and several pieces of gelfoam were later pressed into the area. Discharged the next day, had to be readmitted on 19.8.19 with abdominal distension. Treated as ileus with IV fluids and recovered by 21.8.19.

2.9.19

Another lap chole case had to be readmitted on 4th PO day for severe abdominal pain, possibly pancreatitis. resolved with conservative treatment in 2 days.

23.9.19

Another lap chole landing up in trouble. A young 30 years old male underwent a very difficult lap chole due to the frozen Calot’s triangle and a very thick walled gall bladder. Postoperatively had a bile leak which was 200 cc on the first postoperative day and then continued to decrease in amount gradually drying up in 18 days. MRCP shown below reported a small collection and a ? kink and narrowing at the site of cystic duct-CBD junction. Was it a cystic duct blow-out?

24.9.19

Cystogastrostomy and cholecystectomy in a 65 years old female who was admitted more than 2 months back in ICU for severe pancreatitis. Had developed a big pseudocyst which continued to persist and cause pressure symptoms.

A lot of necrotic debris was also removed from the depth of the pseudocyst cavity.

9.10.19

An attempted lap chole in an 85 years old man (Dr NP Singh’s case) was abandoned, due to dense adhesions and the liver being very hard and cirrhotic with innumerable nodules on its surface.

13.4.19

An atypical Fournier’s gangrene had resulted in perianal sepsis. The patient, a 50 years old male, first presented with pain and tenderness in the scrotum. There was a palpable crepitus in the scrotum – pneumoscrotum. CT scan showed a lot of gas in the scrotum.

The patient was treated with antibiotics and the pneumoscrotum gradually resolved but the patient developed a soft urethral stricture which was dilated.

Also he developed a perianal abscess which was drained. However, this eventually ended up in a complex horse-shoe fistula which was excised.

22.4.19

A supposed hydrocelectomy had to be converted into orchiectomy. Dr jagbir’s case. Hard testicular tumor with necrotic areas.

6.6.19

Called for strangulated right inguinal hernia in a 70 years old male Dr Vikram’s case). REEA of about 6 inches length of gangrenous ileum had to be done.

21.6.19

A huge recurred dermatofibrosarcoma of the left thigh in an elderly female was excised followed by skin grafting of the defect.

25.6.19

Sacrocolpopexy for vault prolapse. Previously had laparoscopic hysterectomy 20 years back at Doraha. (Dr Arora’s case).

26.6.19

Nephrectomy for non-functioning left kidney (due to stones of many decades standing) in a 68 years old female from himachal pradesh.

18.7.19

Sigmoid colon cancer resected with colorectal anastomosis. the adherent ileal loops as well as the adherent part of anterior abdominal wall excised too along with the colon cancer. A colorectal anastomosis and an ileo-ileal anastomosis had be made.

19.7.19

Laparotomy for recurrent episodes of small bowel obstruction in a 58 years old man. At operation, a stricturing tumour of the ileum was found. This was excised and EEA performed. Biopsy report was GIST.