Tag: General Surgery

Fistulated Colonic carcinoma

Dr.Kanakambaran (General Surgery, )

A case of carcinoma of sigmoid colon fistulating into jejunum diagnosed by Be Enema is presented. The contrast from large bowel which has imged the jejunum suggestive of fistula which can be due to Crohn's disease, tuberculosis or malignancy. Here since filling defect is suspected in the colon possibility of carcinoma colon fistulating into jejunum was considered, proved by laparotomy. Another condition when jejunum is imaged by Ba Enema happens, in one of the very rare complications of the most popular operation for chronic duodenal ulcer upto 1980s-- GASTRO JEJUNO COLIC FISTULA.

Choledocho duodenal fistula? Iatrogenic

Dr.Kanakambaran (General Surgery, )

BaMeal xray showing the common bile duct well imaged. Patient underwent? endoscopic sphincterotomy. Details not available

Small intestinal intussusception in anadult

Dr.Kanakambaran (General Surgery, )

Forty two year old woman presented with colicky abdominal paln and vomiting. On abdominal examination a firm mass in the supra umbilical area She was put on nasogastric aspiration and iv fluids initially and BaMeal xray was done which showed typical watch spring appearance suggestive of intussusception. Laparotomy done and jejunojejunal intussusception due to submucous lipoma.

another reason to stay away from mosquitos in Cochin

Dr.Jobi (Laparoscopy, )

a 45 yr old lady presented with a 2 cm subcutaneous inflammatory swelling over manubruim sterni of 3 weeks .It responded to antibiotic therapy , but the swelling persisted with itching. She is diabetic and gives a H/O carcinoma right breast treated 10 yrs back. since the swelling persisted , she underwent an excision biopsy which revealed Dirofilaria worm in subcutaneous fat nodule. Dirofilaria is a vector-borne parasitic disease of dogs and cats and is transmitted by mosquitoes. human are accidental hosts and can present with subcutaneous nodules or occualr filariasis

Deceiving Symptoms but catching the truth

Dr.Praveen (Diabetes, )

72 year old man presented in emergency with complaints of oppressive central chest pain and aches in the back between the scapula 1 day duration. He is a long-standing diabetes and hypertensive patient on treatment. We have done an initial work up for cardiac enzymes ECG echo .Apart from mild leucocytosis others found to be normal.To rule out possibility of dissecting aneurysm CT chest done ,was normal but in the lower cuts of CT they saw a huge calculus in gall bladder with periicholecystic collection.Shifted to GI surgical side and underwent lap cholecystectomy.Discharged next day.

Choledocho duodenalfistula

Dr.Kanakambaran (General Surgery, )

Chronic D.U causing choledocho duodenal fistula treated by truncal vagotomy and G. J. See the barium meal study that shows leak from duodenum to the biliary tree.

A tale of two ulcers

Dr.Rajeev (Gastroenterology, General Practice / Family Medicine, )

Two patients, 38F and 48 M, were seen within the past two weeks and diagnosed with gastric and duodenal ulcers respectively. Both of them gave a history of pain occurring around 2-3 AM. Epigastric pain is a common problem, and ulcer is a frequently suspected diagnosis. However, most patients with epigastric pain do not have ulcer. It is therefore important to know the types of pain that indicate the presence of an underlying ulcer. None of the patients with daytime epigastric pain seen in the past month had ulcer on endoscopy. However, both the patients with 2-3 AM pain had ulcer.

Botox causes fecal incontinence

Dr.Rajeev (Gastroenterology, General Practice / Family Medicine, )

A 39 year old woman, a resident of Canada presented recently in India with fecal and flatus incontinence after she was given Botox 20 U x 2 doses in 1 year ago in Canada. It was done for an anal fissure. She had apparently had a normal colonoscopy prior. There are no signs of spontaneous improvement yet. This complication has affected her ability to work and overall quality of life.