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Showing posts with the label Surgery

Complication during any procedure is part of the game but in timemanagement can make the difference !

Clinical scenario:   A 65-year-old female with no comorbidities presented to the emergency room of King Fahad Medical City, a tertiary care center in Riyadh, Saudi Arabia, with chief complaints of right upper quadrant pain and vomiting for 5 days.  Examination: She was conscious, oriented, jaundiced and hemodynamically stable; she was afebrile and had an oxygen saturation of 94% on room air. She had mild right hypochondriac tenderness, no organomegaly, no palpable lump or free fluid on abdominal examination. Her other systemic examinations were unremarkable. Investigations: Laboratory investigations revealed hemoglobin of 13g/dl , leukocyte count of 14.0 x 10³, predominantly neutrophilic (polymorphs 92%). The liver function tests showed total   bilirubin of 21.6 umol/L , direct bilirubin of 9.7 umol/L, ALT 317 umol/L, AST 300 umol/L, alkaline phosphatase 488 umol/L, GGT 498 umol/L, and amylase 94umol/L. Her renal function test and electrolytes were normal. Abdominal ultrasound r