PakMediNet Discussion Forum : Surgery : general surgery
general surgery
i would like to share a interesting case which we dealt in emergency,
25 years male came with h/o of abdominal distension for one wk associated with vomating & fever for 2 days,,
o/e pt was dehydrated
tachycardiac low blood pressure as well fevrish..
on per abd ex. ebdomen was distended esp upper abdomen, mild tender in left hypochondrium and succussion splash was positive,,
x ray abd dilated stomach
diagnosis made acute gastic dilataion
planned for ex laparotomy after initial resuscitation..
mid line incision made
per op findings were stomach too dilated & ischemic
haemorrahagic fluid found in peritoneal cavity
so total gastrectomy done and ligi darki's pouch made from ileum and anastomosis done..
pt recoverd well post operatively...
what is ur opinion abt the ligi darki's pouch & its outcome in pts with gastric ischemia.
Posted by: HEMAN DASPosts: 2 :: 14-05-2008 :: | Reply to this Message
Re: general surgery
unfortunately i haven't heard of this procedure so far. Please do give reference where can i read about it from.
What i was wondering about was , what could be cause of acute gastric dilatation. Second you didn't mention about NG trial. Straight away going for lap , indications are not clear from your description. Even if we encounter cases of acute gastrtic dilatation usually following splenectomy we treat them conservatively on NG and all usually recover .So this is really interesting that you had to go for laparotomy and then how stomach looked like on opening, it also requires some explaination. all you said is ischemic which does not fully explain the situation. ischemic guts also revive when given warm packs and 100% oxygen. I assume that you must have done all this and stomach must have been unviable and therefore you decided on total gastrectomy.
Posted by: drfarhanPosts: 93 :: 26-05-2008 :: | Reply to this Message