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Subdural hematoma evacuation

Mrs J is a sixty five year old lady who was brought to us with the history of altered sensorium and behavior for a day prior. She had already obtained a ct scan from outside which showed a large subdural hematoma (blood clot) in her brain compressing her brain to the other side. She needed a surgery. She was referred to IGMC Simla, but the family did not have the economic means to take her there. Manali was their last hope.

Having explained all the risks of performing this surgery in a relatively unsupported environment, we did a craniotomy and evacuation of the hematoma here. The lady made a dramatic recovery and is being discharged well. We thank God for the amazing recovery she made and for saving her life.

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Intussusception

Baby K is the son of a Nepali labourer family. The child started crying suddenly at four pm and then started vomiting followed by the passage of currant jelly stools. The young yet astute mother noticed a mass in the abdomen. The child was brought to us  in the night. A working diagnosis of intussusception was made, confirmed by the “Sign de dance” on the plain x ray ( empty right iliac fossa).

Hydroreduction  was attempted but was not successful, hence the infant taken up for surgery, where ileocecal intussusception was found which had approached the sigmoid colon in its extent. Thankfully, on reduction the bowel was viable. A type 1 malrotation had predisposed to this. A cecopexy was performed. ( The bowel was returned to the proper place it was supposed to be in, which was why this happened in the first place).

The baby is now doing well.

 

Ovarian tumour

Mrs. Y came to us with the knowledge of a mass in her abdomen for many years.  A ct demonstratied what looked like an ovarian tumour. She underwent a surgery and this was removed successfully. At surgery it was found torted and gangrenous. She was so stoic that she had only demonstrated mild tenderness the day before!

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Impressive Bladder stones

Dut Kali (name changed) was a middle aged Nepali lady who  presented with long standing inability to pass urine and pain in the lower abdomen. She had undergone an operation in Nepal which failed to cure her. She was diagnosed with bladder stones and underwent a surgery last week succesfully. The entire family was very impressed with the size of the stones.


Achalasia cardia

A young girl presented with the inability to eat and food sticking in the throat. Investigations revealed achalasia cardia. She underwent a successful modified Hellers  and Belsey Mark IV gastroplasty through the thoracic approach. Photographs are attached. We are grateful for the teamwork and for His hand of protection over us. This girl was not able to go elsewhere to get this attended to because of financial constraints.

Bronchoscopy in Manali

Bronchoscopy in ManaliBronchoscopy is now being performed routinely by Dr. Anna. We are very grateful to Dr. Suresh Rajendran who made this possible.

Ileocecal tuberculosis

Rama (name changed) had been sick ever since she delivered her child eight months ago. She had been to many doctors in many cities with no respite. Her condition continued to deteriorate. She was admitted in other hospitals and was brought to us two weeks ago with abdominal pain. Investigations revealed a right sided abdominal mass. She was too sick to be operated upon straightaway since her blood pressure was barely recordable. She was built up and then taken up for surgery. A large right sided ileocecal  mass was found with multiple perforations and fecal fistulae. She underwent a right hemicolectomy and proximal and distal ends were brought out as stomas. She withstood the surgery  and is now on the road to recovery. She turned out to have abdominal tuberculosis.

Dr. Padmaja performing laparoscopic gynaecology

Dr. Padmaja is performing routine laparoscopic gynaecology in Manali. Here she is shown performing a ovarian cystotomy and removal of a fimbrial cyst assisted by Dr. Sarah. Thank you for providing these services to the people of the region.

Dr. Padmaja and Dr. Sarah performing laparoscopy

Large Bladder stone removed

Prakash (name changed) had sustained a pelvic fracture in 2000 and sustained a rupture urethra for which he had a suprapubic cystostomy till 2002 when he underwent a urethroplasty here in our hospital. He had recurrent problems with what he said were pieces of catheter obstructing his urine stream. He came to us last week with a persistant leak via his old spc site and the inability to pass any urine at all. Investigations revealed a huge dumbell shaped bladder stone completely obstructing the bladder neck. He underwent cystolithotomy and removal of this stone and dilatation of his stricture urethra successfully.

 

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