BODELI GENERAL HOSPITAL, Laparoscopy, Hospital, Baroda, Gujarat, India, Surgery

FREE DIAGNOSTIC MULTISPECIALITY CAMP 2009:

A free diagnostic multispeciality camp was organized by BODELI GENERAL HOSPITAL and YUVA SHAKTI SEVA TRUST, BODELI on 1st march 2009 at Chandreshwar party plot, Bodeli.

More than 1500 patients attended the camp and took the advantage of the free services.

The consultation, laboratory investigations, xray, ecg , etc was done free of cost.

Ultrasonography, Sinus endoscopy(FES),Echocardiography all were done with nominal charges.

Medicines were supplied free of cost to all the patients.

Specialities covered were, Internal Medicine, General Surgery, Ear Nose Throat(ENT), Dermatology (Skin), Obstetrics and Gynaecology, Paediatrics ,Radiology and Orthopaedics.

Superspecialities like Cardiology and Urology were also covered.



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CASE REPORT 1. BLUNT ABDOMEN INJURY WITH LIVER TEAR

: A 25 yr old male patient was brought to our hospital in a state of shock , with distension of abdomen, severe abdominal pain and oliguria, with history of blunt abdominal injury 3 days back. He was undergoing treatment from one quack ( there are plenty in interior villages) in a place called paviJetpur.

On examination his pulse was 150/min with systolic BP below 80mm Hg., with severe abdominal distension, guarding and rigidity. X ray abdomen standing was normal other than fluid level in per. cavity. USG Abdomen showed plenty of free fluid which on doing a flank puncture (USG GUIDED) it was blood., also there was doubtful liver tear.

His Hb was 5gm %. S. Creat was 2gm%.We arranged for 2 units of blood and Immediately the patient was posted for emergency laparotomy under general Anaesthesia. On exploration, there was massive haemoperitoneum , with a large liver tear right lobe .Rest every organ was normal. We controlled the bleeding by taking tagging sutures with abgel and compression, and did thorough peritoneal lavage.

Post operatively, patient went into acute renal failure with serum creatinine shooting upto 5mg%.

On consulting a nephrologist, he was advised immediate dialysis. But patient's relatives refused for dialysis. So we continued with balanced IV fluids ,diuretics and antibiotics. Gradually the urine output went on increasing with falling S. Creat. levels, and on the 15th post op. day, it was normal. Gradually patient was made fully oral, with all drains and catheter removed.

He was at last discharged from hospital with 17 days stay.

Again after five days he came back with severe epigastric abdominal pain ,vomiting, tachycardia and fall in BP. We immediately put a ryle's tube. There was a palpable lump in the epigastrium.

On getting done an USG Scan, there was a post traumatic? AV fistula like high velocity flow on the right lobe away from the site of tear, with overlying ? haematoma.

Again we resuscitated him, transfused him 2 units of whole blood, and managed him conservatively for 5 days.

He was once again discharged from Hospital.



CASE REPORT 2 RUPTURED ECTOPIC PREGNANCY Date: 09/01/2006



A 35 yr. old female patient was brought to our hospital with complaints of:

Severe pain abdomen, bleeding per vaginum since 2 days.

No history of amenorrhea, She was multipara and no history of tubectomy.



She was undergoing treatment from some Quack in a village, after which she consulted a physician, and was then referred to our hospital from there.



On Examination : Her pulse was 150/min and BP: Systolic < 100 mm of Hg.

She was pale.

Per abdomen: generalized guarding and rigidity was present.

On Investigations:

X-Ray Abdomen : free fluid in abdomen, No free gas under diaphragm

USG abdomen: Massive haemoperitoneum with right adnexal mass?

Urine pregnancy test: Positive

Haemoglobin was 5 gm%.

So the diagnosis was ruptured right tubal pregnancy, with haemoperitoneum with shock.

We immediately arranged 4 units of whole blood and posted her for emergency laparotomy.

On exploration: there was massive haemoperitoneum with active bleeding, ruptured right tubal Ectopic pregnancy.

Right tubectomy with peritoneal lavage was given

Patient stayed at our hospital for 7 days, and was discharged healthy and happy.



CASE REPORT : 3 FELTY's SYNDROME (Massive splenomegaly with rheumatoid arthritis)



A 65 year old male patient came to us with the complaints of :



Pain and swelling in abdomen for 2years

Low grade fever off and on since 2 years.

Gradual increase in size of the swelling.

Joint pain all over body.

He had been undergoing treatment at SSG Hospital , Baroda and Pipariya Medical college hospital.



On examining and on investigations:

RA factor was positive.

Blood counts were low.

Haemoglobin was 8gm.

There was massive splenomegaly reaching upto the right iliac fossa.

X ray chest suggestive of Old healed pulmonary Koch’s.

Usg abdomen: Massive splenomegaly, rest NAD.



He was diagnosed to be suffering from FELTY’S Syndrome.



We planned him for splenectomy. We prepared him for surgery, arranged 2 units of whole blood, got him immunized my administering Pneumovac. Vaccine.

Splenectomy was done. The specimen was a huge spleen weighing 2.5 kg.

Post operatively patient recovered fast and eventless.

He was discharged from hospital after 7 days stay.



CASE REPORT 4: UNUSUAL PRESENTATION OF TUBERCULOUS PERITONITIS.

A 25 yr. old female patient presented to us with complaints of acute onset severe abdominal pain abdominal distension, vomiting for 1 day.

menstrual history was regular, LMP 3days back, Obstetric history: 1 G 1P.

On examination: Pulse: 120/min, BP: 90mm Hg, systolic., Abdomen was distended and there was severe guarding and rigidity.

USG abdomen and pelvis: Massive Free fluid in abdomen and pelvis, bulky uterine adnexa,

X ray abdomen was Normal.

Laboratory Ix:

Hb: 7.2gm ,TC: 13000/c.mm ,ESR: 120/min, Urine routine and micro: NAD, Urine pregnancy test: Positive.

A Provisional diagnosis of ruptured ectopic pregnancy was made and patient was posted for exploratory laparotomy.

On exploration: there was 1.5 litre of pus in side abdomen, with bilateral pyosalpinx. whole of the bowel was explored and was found to be normal. A thorough peritoneal lavage was given.

A final diagnosis of tuberculous PID was made and patient was put on 4 drug anti tuberculous therapy. and she recovered fast and was discharged from this hospital eventless. test