The patient was having uncontrolled diabetes and was suffering from abdominal pain, fever, and vomiting. He went under several tests and then got referred to us. After he went for Laparoscopic cholecystectomy with drainage of intra abdominal collections, he was successfully treated and discharged.

1. METRO CURING STORY
SEVERE INFECTION FROM GALLSTONES
SUCCESSFULLY TREATED
Consulting Doctor
Dr. Arun Bhardwaj
MBBS, MS (Gen surgery) , DNB (Gen Surgery), FNB (Minimal Access Surgery),
FIAGES, MRCS England, FACS USA, FALS Bariatic Surgery
Senior Consultant & Unit Head
Laparoscopic, GI & Bariatric Surgeon

2. 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.
Patient’s 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.

3. On Evaluation, patient’s 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

4. 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 calot’s 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)

5. 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 OHA’s.

6. Intra – Operative Imaging

8. WE WISH
HIM A
HEALTHY
FUTURE
AHEAD!