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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.
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.
Laboratory investigations revealed hemoglobin of 13g/dl , leukocyte count of 14.0 x 10³,predominantly neutrophilic (polymorphs 92%). The liver function tests showed totalbilirubin 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 revealed a prom…