Dr Mohinder Singh's blog

30.7.24

All lab investigations and the ultrasound scan were normal in a 50-year-old male presenting with pain and local tenderness over McBurney’ point. The tenderness was exquisite and included some rebound tenderness. At operation, the appendix (preileal in position) presented itself in the wound before even before the cecum could be visualized.

lesson – the most important part of making a diagnosis of acute appendicitis remains proper history and clinical examination rather than labs and scans.

15.7.24

A difficult lap chole had to be performed in a 17 years old young man with acute cholecystitis. At operation, thick pus had to be aspirated to grasp the fundus, and thereafter the stone had to be disimpacted to make dissection easier. Even then the cystic duct junction with the bile duct could not be defined. The gallbladder neck was just ligated under the H. pouch and gallbladder removed.