Gall Stones Sever Infection Curing Story - Metro Park Hospital Palam Vihar

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METRO CURING STORY
SEVERE INFECTION FROM GALLSTONES
SUCCESSFULLY TREATED
Consulting Doctor
Dr. Arun Bhardwaj
Senior Consultant Unit Head Laparoscopic, GI
Bariatric Surgeon
MBBS, MS (Gen surgery) , DNB (Gen Surgery), FNB
(Minimal Access Surgery),FIAGES, MRCS England,
FACS USA, FALS Bariatic Surgery
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• Mr. Kundan Singh, 49 yr old male patient was
  suffering from uncontrolled diabetes.
• He was admitted under Physician care with Fever,
  Pain abdomen and Vomiting for 3 4 days.
• Patients medical parameters were as follows
• Biochemical parameters
• TLC 15,100 LFT, KFT Normal
• USG Acute calculus cholecystitis (two calculi
  12 mm 11 mm noted in neck region)
• GB thickened and edematous with pericholecystic
  free fluid.
• So, he was referred to us.

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• On Evaluation, patients parameters were as
  follows
• Tachycardia 100/min
• BP 130/80 mm Hg
• He had raised blood sugars was put on insulin
  Infusion.
• P/A Acute abdomen with generalized tenderness
  and guarding.
• WBC count was increased to 22,000.
• CT scan abdomen showed edematous gall bladder
  with moderate fluid in peritoneal cavity
  and mild pleural effusion.
• Patient underwent Laparoscopic cholecystectomy
  with drainage of intra abdominal collections

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• Intra-operative findings
• Phlegmon formation with dense omental adhesions
  to anterior abdominal wall liver.
• Gall bladder was acutely inflamed with
  gangrenous patches and perforation. Presence of
  pus multiple calculi in the gall bladder.
• He was having multiple inter-abdominal abscess
  with approx 1 litre pus collection in sub-
  diaphragmatic space, paracolic gutters pelvis.
• The calots triangle was Frozen with dense
  adhesions
  Thorough peritoneal cleaning was done.
• The Surgery was completed laparoscopically and
  two drains were placed (one in sub-hepatic
  space other in pelvis)

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• Post Operative Period
• The patient was shifted to ICU subsequently to
  ward.
• His tachycardia and raised WBC count settled.
• He received 1 unit of PRBC to replace
  intra-operative loss.
• He was started on oral feeds gradually from
  POD2.
• His pelvic sub-hepatic drain was removed.
• He was discharged in stable condition.
• The Patient is doing well at 1 month follow up
  with sugars controlled on OHAs.

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Intra Operative Imaging
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WE WISHHIM AHEALTHYFUTUREAHEAD!