We plan to describe rare and difficult Gastrointestinal surgical cases with there images for the benefit of general and gastro surgeons
Obscure GI Haemorrhage
A case of obscure lower gastrointestinal bleed- detected to have jejunal diverticulae. Was detected on MR enteroclysis. Planned and did resection of involved segment. Pt did well and was discharged on 7the Post op day
A 56 year old patient presented with colorectal cancer – operated with resection and anastomosis of the involved colon. The tumour was completely excised and the ends joined. No colostomy was required.
We presented a case of a 42 year old patient, who had a laparoscopic cholecystectomy and had a bile leak. He had a stormy course, required multiple surgeries - 2 before coming to our hospital and three surgeries at our hospital. He was in ICU for a long time, but he has recovered and was discharged. Various photographs are attached. Initially we had to leave the abdomen open and later the mesh was removed and skin grafting was done. Also important was that this patient had a 4-5 mm Common hepatic duct when we did hepatico-jejunostomy roux enY. this also worked well for the patient.
We feel the incidence of diverticular disease is gradually increasing in our country. We have recently seen a number of cases with different presentations. cases with jejunal diverticuli with upper GI bleed. One was detected on push enteroscopy, one suspected on MR enteroclysis and one detected at laparotomy. The last patient had a rare blood group(O negative) and bled continuously, suspected to have colonic diverticulae. He was operated early because of rare blood group and we were able to resect the segment responsible and patient improved. Apart from this we recently saw many patients with sigmoid colonic diverticulae presenting with perforated diverticulae and diverticulitis and colo-vesical fistulae.