Data presentation showing cases done at tertiary care centre at Shimla

1. Surgery Unit 2
DATA PRESENTATION FOR MONTH OF NOVEMBER 2023
Department of General Surgery

2. Introduction
Index Male Female Total
Admissions
Discharges
Directly observed treatment
short course (DOTS)
Deaths 003 000 003

3. Death 1
Name Balu Ram CR No. 202311102506
Age 52 years Sex Male
DOA 07-Nov-2023 DOD 08-Nov-2023
Diagnosis Acute generalised peritonitis cause ?bowel ischemia
Management
KCO SMA thrombosis status post SMA stenting, presented with
?mesenteric ischemia with shock with deranged coagulation profile and
metabolic acidosis. Managed conservatively as not fit for surgical
exploration.
Cause of death
Septic shock with MODS cause acute mesenteric ischemia following SMA
stent thrombosis

4. Death 2
Name Dr. RL Gupta CR No. 202311201868
Age 84 years Sex Male
DOA 21-Nov-2023 DOD 24-Nov-2023
Diagnosis
Type 2 diabetes Miletus with hypertension with anaemia secondary to
haemorrhoids with ?multiple myeloma with chronic cough
Management
Patient managed conservatively. There was progressive fall in
haemoglobin, blood transfusion was planned but cross-match was not
successful due to autoimmune antibodies (positive coombs test)
Cause of death
Myocardial infraction due to severe anaemia with diabetic kidney disease
with gastroparesis with positive coombs test (autoimmune phenomenon)

5. Death 3
Name Krishan Dass CR No. 202311027881
Age 70 years Sex Male
DOA 21-Nov-2023 DOD 28-Nov-2023
Diagnosis FUC of Ca Stomach with gastric outlet obstruction
Management
Patient presented in casualty with shock, resuscitated and was planned
for feeding jejunostomy. Surgery deferred because the patient was not
haemodynamically stable. On PAD-5, faecal matter was present in ryles
tube
Cause of death
Septic shock with MODS cause Ca stomach with gastric outlet
obstruction with aspiration pneumonitis.

6. Surgeries Performed
Elective Surgeries 70
Emergency Surgeries 18
Major Surgeries 88
Minor Surgeries 122

7. Emergency Surgeries
Sr. No Procedure Indication Number
01 Emergency appendectomy Acute appendicitis 06
02 Right high inguinal orchidectomy
Right testicular mass ?testicular
malignancy
01
03
FUC of Near total gastrectomy with D2
lymphadenectomy with acute generalized
peritonitis cause GJ anastomotic leak
E/l with thal patch repair of GJ
anastomotic leak with Braun
jejuno-jejunostomy with PTPD
01
04 Left above knee amputation PVD with acute limb ischemia 01
05 Incision and drainage Breast abscess 01

8. Emergency Surgeries cont.…
Sr. No Procedure Indication Number
06 Below knee amputation Diabetic foot 01
07
E/l with omental patch
closure for DU
preformation
Acute Gernalised peritonitis
01
08
Modified Wetzel feeding
jejunostomy
Absolute dysphagia cause Ca esophagus 01
09
Restoration anastomosis
(Illeostomy closure)
• FUC total proctoceostomy With ileal pouch
anastomosis with covering loop colostomy
• FUC of E/l with primary closure of ileal
perforation with proximal loop ileostomy
• FUC of right extended hemicolectomy with
CME with CVL with ileostomy with distal
mucus fistula with D3 lymphadenectomy
03

9. Major Surgeries
liver and pancreas
Sr. No Procedure Indication Number
1 Laparoscopic cholecystectomy Gallstone disease 42
2
Laparoscopic converted to Open
cholecystectomy
Gallstone disease (02)
FUC cholecystostomy (01)
03
3 Laparoscopic completion cholecystectomy FUC subtotal cholecystectomy 02
4
E/l loop gastrojejunostomy with
interaortocaval LN sampling
Locally advanced CaGB with PTBD
in situ
01
5
E/l with closure for unresectable growth
suspected CaGB/cholangiocarcinoma.
Incidentally detected CaGB post
laparoscopic cholecystectomy
01
6
Completion extended cholecystectomy with
epigastric port site excision
Incidentally detected CaGB 01

10. Major Surgeries
stomach and intestine
Sr. No Procedure Indication Number
1
Total gastrectomy with D2
lymphadenectomy with Roux-en-Y
esophagojejunostomy
Ca stomach 01
2
Total gastrectomy with Roux-en-Y
esophagojejunostomy
Poorly differentiated
adenocarcinoma stomach
01
3 Diversion loop colostomy Metastatic malignant melanoma 01

11. Major Surgeries
kidney and ureter
Sr. No Procedure Indication Number
1 Nephrectomy Non-functioning kidney 01
2 Pyelolithotomy Staghorn calculus 02

12. Major Surgeries
hernia
Sr. NO Procedure Indication Number
1 TAPP Inguinal hernia 02
2 LTFMH Inguinal hernia 03

13. Major Surgeries
breast
Sr..No Procedure Indication Number
1 Modified radical mastectomy Carcinoma breast 01
2
Breast conservation surgery and
axillary lymph node dissection
Invasive ductal cell carcinoma 01

14. Major Surgeries
miscellaneous
Sr. No Procedure Indication Number
1 Level 3 lymphatic duct ligation FUC MRND with chyle leak 01
2 Chemoport insertion Chemotherapy for malignancy 02
3 Excision of AV malformation AV malformation 01
4
Excision of retroperitoneal
neurofibroma
Retroperitoneal neurofibroma 01
5 Excision of neurofibroma vagus Neurofibroma left vagus 01

15. Thank You