2.4.24

A 45 years old lady presented with a big painful swelling below the umbilicus which was diagnosed clinically as PUH, possibly obstructed. At operation instead, the swelling turned out to be a chronic abscess full of thick pus. Further exploration showed a foreign body emerging out of a small hole in the rectus sheath, and on enlarging the opening in the sheath, a full sized abdominal pack could be pulled out (gossypiboma), possibly retained during TAH on 9.11.23. The drain continued to drain thick pus for 3 weeks and then dried out, with full recovery.

19.4.24

Lap chole in a 50 years old female turned out to be very difficult due to dense fibrosis in the Calot’s triangle. She had a very big stone (34 mm on US) impacted in the neck of gallbladder, the stone was disimpacted and removed. Still no safe progress could be made in dissection of the area due to dense fibrosis, and the case was converted to open after 2 hours.
At open operation, the thick mass at the neck of gallbladder could be separated from the underlying bile duct which however was denuded to expose the mucosa which appeared to be intact. The drain, however, continued to drain bile for a little more than 3 weeks and then dried out.