We plan to describe rare and difficult Gastrointestinal surgical cases with there images for the benefit of general and gastro surgeons
Polypoidal Malignant Lesion in the Colon
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Patient was 65 years old. Had bleeding per rectum. Investigated and found to have this lesion in distal part of the colon. The part of the colon was resected.
Cystic lesion of pancreas treated with distal pancreatico-splenectomy A 62 yearold gentleman presented to us with complaints of upper abdominal pain with radiation to back since 2 months. He also complained of weight loss, however this was not significant. Ultrasound and contrast enhanced CT scan of the abdomen (figure 1) was suggestive of a cystic lesion in body and tail of pancreas. To further characterize the lesion a MRI with MRCP of the abdomen was done. This was suggestive of a mixed-micro & macro-cystic lesion in tail of pancreas. A communication between the lesion and pancreatic duct was demonstrated (figure 2). These features pointed to a branch duct intraductal papillary mucinous neoplasm (BD-IPMN). An endoscopic ultrasound (figure 3) was suggestive of a mixed micro- and macrocystic lesion of pancreas and myxoid material was aspirated. The cyst fluid amylase and CEA was 154 U/L and 0.12 ng/ml respectively and were normal, indicating a non-mucinous cyst. In view o
Clinical History A 50 year female presented to the emergency of Metro Multispeciality Hospital with a h/o of acute abdominal pain and recurrent vomiting of 3-4 hours duration and a painful tender swelling in the mid abdomen. She gave a h/o of a swelling in the supra-umbilical region for the last 2-3 years. Clinical examination revealed a tender. Irreducible para-umbilical hernia. Large Irreducible Supraumbilical Swelling Urgent CT abdomen confirmed a small intestinal loop to be stuck in the hernia sack. She was taken up for urgent laparotomy within 2 hours of presentation to the emergency .On opening the hernia sac a discoloured loop of small intestine was seen. The constricting ring was released and the intestine regained its normal colour and viability – allowing for the intestine to be saved. Patient underwent a Mesh Henioplasty and was discharged on the 2nd post operative day. TIMELY AND QUICK INTERVENTION SAVED THE PATIENT FROM AN INTESTINAL RESECTION AND ALLOWED FOR A QUICK
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