Dr Mohinder Singh's blog

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.

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.

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.

6.11.2006

A lap chole on a male doctor from Amritsar (Dr Amandeep Singh from SGRDMC) was a difficult one due to thick walls; the port dilated to remove the big gall bladder and so the sheath in that port had to be closed.

A pantaloon hernia in a 65 years old male was repaired with mesh. Both big sacs of the direct type and the indirect type were present.

16.9.2006

Apparently easy case in a 50 years old woman. Actually very difficult due to unexpected empyema;  the pus was aspirated. The grasp at the neck was difficult; broke a grasper. The CD was very short;  the wall of the gallbladder was very adherent to the liver bed; the liver bled badly to cause hypotension; the liver sinus had to be sutured when it could not be controlled by cautery. The port was enlarged to remove the gallbladder and the big hard stone (2 cm) separately in a bag ( the stone could not be grasped).

Another lap chole in a 50 years old female was not so difficult ; but the big stone in neck when held in spoon forceps broke the spoon forceps; the port had to be enlarged to remove the gall bladder.

12.11.06

A parathyroid adenoma  of the left lower parathyroid gland (4X2 cm) was excised through a lower neck transverse incision. The patient had been referred from urology when they investigated her for large bilateral staghorn kidney stones. Earlier the patient had presented to the orthopedics department for backache and generalized weakness. They referred her to urology when they found the bilateral kidney stones.

2.10.06 (Dussehra holiday)

An emergency laparotomy (on a holiday) for obstructing colon cancer. The patient was a staff nurse Paramjit Kaur Hundal 45 years old admitted with large bowel obstruction and bleeding per rectum. Family history of large bowel cancer was present. Colonoscopy showed a lesion at 60 cm, and CT scan showed a big growth at splenic flexure. Biopsy (colonoscopic)  – adenocarcinoma WD.

An extended right hemicolectomy was performed. Specimen showed a big tumor near splenic flexure and lots of ulcerations and nodules in an area of angry-looking field change proximal to the tumor.

Remains well till last seen (2015 November).

28.9.2006

My classfellow in school from Samana (Naresh Peter) presented with a left inguinal hernia and an undescended testis on the same side. The testis was found in the canal and removed; the hernia was repaired with a mesh.