1. MORNING MEETING 09 Feb
2024
Senior Registrar : Dr Muhammad Rashid
Morning EOT+Night COD batch incharge:
Dr Kamran
Morning COD+ Night EOT batch incharge:
Dr Tayyaba
2. Total Patient : 175
Male : 145
Female : 30
MLC : 10
RTA : 40
FAI : 05
Burn : 10
Expire : 03
LAMA : 04
Operative : 08
3. Exploratory laprotomy + repair of gastric
perforation +debridment of lacerated wound
• Pt Nadeem 21y/M presented in surgical SER with H/O stab injury by knife at
lower abdomen 1 hour back
Vital: BP 150/90 PR 67/min SPO² 97% Temp A/F
Labs Hb : 13.5 PLTs : 303. WBC : 10.8. Urea 34.5 Creat. : 1.1
O/E: There is a 2*3 cm protrusion of momentum from wound 5 cm above
umbilicus
Abd. : tense , tender on palpation .
ON DRE : Normal anal tone , No anal fissure ,collapsed rectum ,fecal staining +
4. Surgeons: Dr Muhammad (SR) , Dr Tayyaba , Dr .Aiza
IOF:
1*2 cm lacerated wound in anterior abdomen wall 6 cm above
umbilicus with momentum herniating through it
1*1cm perforation.on anterior wall of stomach.
10. Exploratory Laprotomy + Abdominal lavage
• Pt Amina 30y/Female presented to us in SER with Hx of abdominal
distension and 2 episodes of vomiting from 1 week
• Vitals: BP 130/80 ,Pulse=128 ,RR=16 ,SpO2=99%
• O/E
• Generalized Abd. Distension , tense and tender in all quadrants
• DRE normal anal tone, no mass palpable,fecal staining present
• Labs Tlc: 12.1 , Hb: 9.2 ,Plt: 449
• USG: Gut loops mildly dilated with sluggish peristalsis.
11. Findings
• Surgeon
• Dr Rasheed (SR) DR Aizaz Dr Tayyaba Dr Aiza
• IOF
• 5 Liter of frank pus drained on opening abdomen
• Frozen abdomen and pelvis
• Multiple interloop pus pockets.
• Inflamed B/L fallopian tubes.
12. Release Incision
• Pt M.Javed 55y/M presented in SER with Rt. leg abscess around knee joint from 7
days and H/O fever from 2 days .
• VITALS: BP 110/70 PR 100 SPO² 97% RR 17
• O/E :Erythematous, tense , tender Rt. knee with limitation of movement
• Abd : Soft , non-tender , B/S audible
• LABS: HB 6.6 TLC 6.6 PLTs 166 Bilirubin (total) : 24.8
13. Findings
• Surgeons: Dr Tayyaba Dr Adan Dr Hamza
• IOF:
à 120 ml of foul smelling pus drained and drain placed.
14. Debridment of Fournier Gangrene
• Pt Raja Masih 28/M presented in SER with complaint of gluteal abscess from 14
days and scrotal swelling from 2 days.
VITALS: BP 100/60 PR 106 RR 17 SPO² 90
Labs: Hb 11.9 TLC 9.2 PLTs 218
Urea 94.8. Creat : 2.2
O/E : 20 * 25 cm scrotal swelling with necrotised tissue around anus .
Abd. : soft, non tender + B/S audible
15. Findings
SURGEONS: Dr Aizaz Dr Tayyaba Dr Aiza
IOF:
à 500 ml of pus dicharged
à Necrotic skin + subcutaneous tissue of bilateral scrotum
à Healthy B/L testis
à Extensive chemical + mechanical debridement done
16.
17. Exploratory laparotomy + stitching of scrotal
laceration
• Pt name Qamar din 50y/M presented to SER with complaint of
urogenital injury due to fall from tree
• On arrival Bp was not detectable but after resuscitation Vitals were.
Bp 80/50 pulse 56/min. Resp. Rate. 22/min
• O/E : laceration of 3*1cm at right inguinal region + penile base
• Laceration of 5*4 cm over front of testes.
• Abd : Soft , tender all quadrants
18. Labs
• WBC : 23.3
• HB : 6.4
• PLTs : 223
• FAST scan : Streak of fluid seen in pelvis between bowel loops .
Minimal amount of free fluid around spleen.
19. Findings
• Surgeons : Dr Rasheed (SR) , Dr. Aizaz , Dr. Aiza
• IOF
• Zone 2 and 3 non expanding hematoma
• Rest of the abdominal viscera are unremarkable
20. Abdomen Closure + Re-anchoring of Stoma
• Pt Afzal/Male admitted in ward was brought to EOT for abdomen closure
using tension relieving suture.
• Vitals : Bp :110/70. Pulse :96/min. RR :16
• Labs : WBC : 16.8 Hb : 11.0. PLTs :464
• Surgeon : Dr. Tayyaba , Dr. Aiza , Dr. Hamza
• IOF
• Jumbled up gut
• Rectus deficient in midline
• 10 ml of parastomal pus drained
