LAPAROTOMY

Case-1

42 yr old male came with history of multiple surgeries for gun shot injury following which he devolved enterocutaneous fistula discharging faecal matter , CECT abdomen done and MR fistulogram showed midline and left iliac fossa hernia with fistula communicating with descending colon , patient undewent diagnostic laparoscopy with exploratory laparotomy with colonic and small bowel resection with both hernia repair , it was a tedious job patient was given parenteral nutrition and was discharged on the 5 post operative day , thanx God and kalka ma for blessing us.


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Case-2

74 year old patient came in causality , case of perforation peritonitis 3 days no urine output , in septic Shock Bp- of 60/40 , at 10 pm in night , our micu team did gr8 work all lines was put , fluid given , blood plasma arranged for surgery , at around 1 pm we took him for surgery . On exploration patient had perforated caecum , and terminal ileum , right hemicolectomy done , by 3 we were done with surgery ,it was a team work including my team dr Sachin , anaesthetist dr Gaurav . Post operative period result was astonishing next day patient extubated , started on early TPN and albumin , 8 days he was discharged on soft diet.