Author Archive
Thyroid lobectomy ending up in external jugular vein laceration, a breast conserving lumpectomy for suspicious lump of breast
Posted on: February 1, 2007
1. A neat thyroid lobectomy in a 20 years old female for a follicular adenoma. however, the vacuum suction drain pump rapidly filled up with blood – re-explored to find a laceration in the external jugular vein by the drain trocar. The rent was sutured.
2. A 45 years old female with a 2 cm cystic and solid mass in the superolateral part of right breast on mammograhpy, and clinically impalpable axillary nodes. histopathology was unclear. A lumpectomy and SLN bx was planned; methylene blue did stain a node; but had some other enlarged nodes ; so removed all – sort of axillary clearance was done. At final histopathology, no LN came out to be involved. However, the oncologist decided to go ahead with chemotherapy.
26.1.07
Marriage attended at Kohinoor marriage palace Rajpura road.
25.1.07
Bascom operation for pilonidal sinus – first time; The patient was an intern.
22.1.07
Mehar Singh (worker at Principal Dr Kiranjit Kaur’s farm), a 50 year old male, had perforation (typhoid ileal perforation) peritonitis 4 months back and had the perforation closed. This leaked and then an ileostomy was made. This was now closed.
2 easy lap choles
Posted on: January 15, 2007
15.1.07
1. 35 years old female with an easy gall bladder.
2. 35 years old female with a gall bladder with with a short cystic duct.
11.1.07
Lipoma oral cavity diagnosed as mucus cyst.
Called to help at nephrectomy for big upper pole renal cancer adherent with the liver. The exposure was inadequate.. Improved exposure led to an easy nephrectomy.
Ileocecal tuberculosis misdiagnosed as appendicitis, and a fallacy of perception in lap chole
Posted on: January 8, 2007
7.1.2007
A fallacy of perception at lap chole occurred in a 35 years old talkative lady (relative of daughter-in-law of dr Modi). The long narrow neck of gallbladder was perceived as the cystic duct and thus the dissection remained at a higher level leading to confusions in anatomy, and the cystic artery not being found. A further lower dissection revealed the cystic duct at lower level, with the artery behind it in dense adhesions in the Calot’s triangle.
25 years old male from Jagraon was diagnosed as appendicitis and appendicectomy done at civil hospital Jagraon. Biopsy of appendix was reported as tuberculosis. Was started on antituberculous therapy. Had taken these drugs for 2 months, but continued to have attacks of intestinal obstruction.
At operation, the caecum was found to be contracted and and terminal ileum tightly strictured 2 strictures proximal to cecum along with other multiple strictures proximally. This 15 cm length of terminal ileum with strictures and cecum were excised and EEA done.
4.1.07
OP Sharma a 55 years old obese male with a French-cut beard presented with features of intestinal obstruction. Had a laparotomy previously in 1993 (Dr Mahesh Gupta) for abdominal pain at which probably (no records available) adhesiolysis was done and thereafter the patient was started on ATT (antitubercular therapy) initially for 6 months and then again for one and half years. The symptoms persisted. Dr Pramod, the gastroenterologist, then got a BMFT done. This revealed strictures in the small intestine.
At laparotomy now, dense adhesions were encountered in the RIF. These were lysed. A band obstructing the midileum was divided. And then 3 strictures in the proximal ileum in a segment of 6 inches were resected and an EEA done.
TAH with BSOP with infracolic omentectomy 65 f with previous h/o MRM for breast cancer in 1982. Dr Mohi later reported that the biopsy report turned out to be cancer of the fallopian tube which according to her was rare.
Punctate globular sialadenitis – parotidectomy; and a seminar on early breast cancer
Posted on: December 8, 2006
7.12.2006
Parotidectomy : shama devi from the hills (himachal) with long history of pus discharge from right parotid duct, not responding to medical treatment; the gland itself not enlarged but slightly tender to touch. Sialography – globular punctate sialadenitis. The whole gland was removed, including the deep lobe.
She continued to have slight salivary discharge from mouth, possibly from some part of the deep lobe inadvertently left behind. This was injected with absolute alcohol through the duct intraorally; thereafter the the discharge dried up.
8.12.2006
Conducted a seminar on early breast cancer in the seminar room at 5 pm.
3 easy lap choles
Posted on: December 4, 2006
3 lap choles easy all easy.
23.11.2006
Open CBD Exploration with cholecystectomy was performed in a 60 years old female from Kurukshetra ; shifted from medical ward with jaundice due to stones – ERCP and ES at GMCH sector 32 CHD with 25 stones removed but still bilirubin was 4, so open exploration was decided; found one big stone still in the CBD. It was removed and a T-tube kept in the CBD.
2. Dr Grover did his first hernia TEP repair that I had to assist.
Dr Mohinder Singh's blog 