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Sushruta- June Sushruta Newsletter of Surgical Society of Bangalore June 2020 Dr. Kalaivani.V Dr. Venkatachala K Dr. Venkatesh K L Dr. Sreekar Pai A Dr. Manish Joshi President President Elect. Hon.Secretary Hon. Jt. Secretary Hon. Treasurer Table of Contents 1. Editorial 2. Letters to the Editor 3. Monthly Clinical Meeting Report (Online) 4. Monthly Clinical Meeting Presentations (Online) 5. Interview with Surgeon - Dr Chanchal Raj Chhallani 6. Hyperbaric Oxygen Therapy - Controversies Arosen! 7. Short Note on Surgical Training 8. Rare Experiences in Surgeon's Life 9. How Did They Die? !!!! 10. Risk Factors for Mortality After Emergency Laparotomy: Scoping Systematic Review 11. Obituary 12. A World Full of Irony 13. Classifieds | Trivia | Upcoming Events 14. Sushruta Editorial Board Send your News, Articles, Event details, Classifieds, etc. to "[email protected]" Page 1 ಸುಶುÕತ Newsletter of Surgical Society of Bangalore June 2020 Editorial Dear Esteemed Member of SSB, ‘SUSHRUTA’ is a monthly newsletter, creating a platform where in the members and surgical postgraduates can publish original articles, case reports, surgical guidelines or any other material of surgical relevance, This will be made available online for all the members. I request everyone to make use of this platform to disseminate, share or acquire knowledge. Dr Kalaivani V President SSB KSCASI CC Dear All, Kindly encourage this new monthly initiative of the SSB. Academic Articles Non-Academic Inviting articles - That may be appropriate and Please send articles, guidelines, humour, interesting to the SSB members. Examples: life stories, trivia, quiz questions and interesting beyond surgery, my daily routine, how I manage Case report or case series with Review of stress, interesting place I traveled, books I literature for academic purposes. recommend etc. Opportunities / Classifieds Feedback / Suggestions Relevant Jobs, Ad's and upcoming events can Any other suggestions for improvements, be included at a nominal fee as per the feedback, letters to the editor, inputs are discretion of the Editorial team. welcome. Deadline : Please mark all your contributions via emails, Last day of every month. WhatsApp with the heading for Sushruta and mention your name, designation and Send your article to : [email protected] institution. WhatsApp - 8197910166 Request all the SSB members to actively contribute, participate and wholeheartedly appreciate this new initiative "Sushruta - official newsletter of the Surgical society of Bangalore" Regards, The Editorial team of Sushruta Page 2 ಸುಶುÕತ Newsletter of Surgical Society of Bangalore June 2020 Letters to the Editor Dr.Kalaivani, Dr.Venkatesh & all the E.C. Members, I don’t need any other Honours than this , I am Touched & Moved . A Very Big Thnx to the Entire Executive Com Members with special Thnx to Dr. Manish Joshi our EDITORIAL Chief for the interview. - Dr Ashok Kumar K V Great effort! Proud of SSB Very nicely done. Many Congratulations to you Nice write up of Ashok Kumar Sir and your Editorial team Kalaivani!!. - Dr. M Ramesh -Dr Arvind Gubbi Very well compiled news letter. It makes I am expessing my sicere NAMASKARS to the a very interesting & varied reading. Sushruta editorial board for putting in the news letter. Congratulations to the whole team Regards - Dr. Srinath -Dr S A Subramani Great interview Sir. A good read for Dr Rajiv Lochan’s article “Sunshine” makes us everyone and surgeons in particular. to reflect more on our actions. Many times we Great effort Dr Kalaivani and team. Well face such dilemmas. done. - Dr Rajshekar Nayak Surgical practice has many faces- medical, moral, ethical, social etc. You are a great good example for every one in younger generation sir. Sad part is...by the time we understand all or Great initative by dr Kalaivani and team some of this, we would have crossed 60 ! or may not think about it at all !! -Dr Nagesh NS Thanks & congratulations Dr Rajiv & team. - Dr Shivaram HV Page 3 Sushruta Newsletter of Surgical Society of Bangalore June 2020 Online Monthly Clinical Meeting Thank-You Dr. B.R Ambedkar Medical College and Vydehi Institute of Medical Sciences for organising this MCM Feedback & Comments Thank Dr Ramesh from Vydehi institute and Dr Ramesh from AMC for a very good scientific session. Dr Kalaivani Thank you Dr. Ramesh of AMC & Dr. Ramesh Reddy of Vydehi for the excellent Scientific Meeting.. Congratulations Dr Murali Congratulations both Ramesh. Very good session -Dr Srikanth KN Dear all Drs. of SSB. I am very happy to see the pictures of Surg. Clinical Meeting of June 2020.I should thank & Congratulate for good proceedings & pictures sent. For senior citizens there will be some technical difficulty in viewing live programmes. I am very happy you have sent pictures & I was able to see early morning. Let this continue. My suggestion is even after Clinical Meetings start with Dinner & Drinks also this typing of sending pictures & Description on paper continue as it will help those unable to attend the Clinical Meetings. Let this go on with other meetings also. Thanks. Dr. B. G. S. Murthy 9343207939. Send your News, Articles, Event details, Classifieds, etc. to "[email protected]" Page 4 ಸುಶುÕತ Newsletter of Surgical Society of Bangalore June 2020 Best Poster Online Monthly Clinical Meeting - Presentations Gastric volvulus, Challenges & Solution in Management: Case Report Presenters : Dr.Tinnu George, Dr. Ravi Kumar.H, Dr. Sai Kalyan Guptha A, Department of General Surgery, Vydehi Institute of Medical Sciences and Research Center - Bangalore Dr Tinnu George Introduction Gastric Volvulus is twisting of all or part of the Stomach by more than 180 degrees with obstruction of the flow. In 1886 Berti was the first to describe a gastric volvulus after performing an autopsy on female patient. Usually associated with diaphragmatic defect. Incidence is equal in both genders. About 20% of cases occur in children or after the 5th decade of life. Gastric volvulus is an uncommon cause of gastric obstruction (closed loop obstruction) but its intermittent nature and vague symptoms may make diagnosis difficult. Case Report A 30 year old male presented with complains of abdominal pain and distension from 2 days, with Vomiting 2-3 episodes, immediately after food, associated with H/o breathing difficulty since 2 day, on examination patient was conscious and oriented, pulse 100bpm and BP 150/100mmHg. Spo2-90% at RA, with RR of 24c/m, per abdomen was diffusely distended with epigastric tenderness, guarding and rigidity, bowel sounds sluggish. Lab investigation showed only raised total leucocyte counts, remaining parameters were normal, x- ray chest showed abdominal contents in left hemi-thorax, x-ray erect abdomen showed double air fluid level. CECT was s/o diaphragmatic hernia with deviation in stomach axis, patient was taken up for exploratory laparotomy intraoperatively stomach was grossly distended and mal-rotated (organo-axially)which couldn’t be de-rotated, 1cm gastrotomy made on the stomach and 7.5 litres of partially digested food aspirated, ligaments of stomach released and stomach is de-rotated to its anatomical position. Colon and omentum are reduced into the abdominal cavity from thorax. Diaphragmatic defect noted and plication done, prolene mesh placed 15 x 15 cm. Anterior gastropexy was done with prolene sutures. And FJ performed. ADK drain placed. ICD placed in the left hemithorax. ICD removed on POD3. POD5 patient developed burst abdomen and tension suturing done. Patient sent home with FJ in situ, later removed after 4 weeks. Patient recovered well, with no recurrence of symptoms till 6 months. Discussion Gastric volvulus is a rare condition. Cardia and the pylorus are the fixed points. The clinical presentation depends on the degree of rotation and time of onset. Acute volvulus usually presents with abdominal or chest pain, severe vomiting and epigastric distension. Borchardt triad (pain, retching and inability to pass a nasogastric tube) occurs in up to 70% of cases. Torsion occurs along the stomach’s longitudinal axis (organo-axial) in 70% of cases, vertical axis (mesentro-axial) in 30% cases and combined. Type 1 (primary) idiopathic is due to laxity of gastro-colic, gastro-splenic, gastro-phrenic and gastro-hepatic ligaments. It’s also associated with congenital asplenia and wandering spleen. Type 2 (secondary) is associated with congenital or acquired abnormalities like diaphragmatic defects and post hepatic transplant. Conclusion Gastric Volvulus is an unusual entity, often not recognized at an early stage, which can become a surgical emergency. Gastric Volvulus presents more frequently with intermittent symptoms. Timely diagnosis and treatment of acute gastric volvulus can potentially decrease morbidity and mortality Page 5 Sushruta Newsletter of Surgical Society of Bangalore June 2020 Best Paper Online Monthly Clinical Meeting - Presentations FOURNIER’S GANGRENE: A RECONSTRUCTIVE CHALLENGE – OUR EXPERIENCE Presenter - Dr Sanyal Sumbul Rana (P.G.Student) Department of General Surgery Dr B R Ambedkar Medical College - Bangalore Background Fournier’s gangrene is an acute, rapidly progressive and potentially fatal, necrotizing fasciitis. Reconstruction of the scrotal, penile and perineal defect after the initial debridement is a challenge as these organs have unique texture, contour and function. Extensive destruction of the surrounding skin, over the abdominal wall, thigh and the gluteal region, limits the skin available for the reconstruction. Proximity to anus and contamination with urine, contributes to poor results. There is no consensus on the best method of reconstruction. To avoid erroneous reconstruction , in 2015 Karian et al proposed a simple algorithm based reconstruction. We have improvised the algorithm to add anal sphincteroplasty and vaginal reconstruction and we aim to study the algorithm based various options in Dr Sanyal Sumbul Rana reconstruction and their outcome. Methods Our Aim of the study was to study the algorithm based choice of reconstruction options, their indications and outcome in terms of hospital stay, functional outcome and the cosmesis of the surgery with patient satisfaction.
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