Papers by PRIYANKA TIWARI
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018
A 68-year-old male presented with a complaint of severe epigastric pain for seven days, not relat... more A 68-year-old male presented with a complaint of severe epigastric pain for seven days, not related to food intake, nausea, vomiting, jaundice or diarrhoea. He had similar albeit mild complaints occasionally during the past year for which he underwent laparoscopic cholecystectomy one year back and was admitted with a diagnosis of acute mild pancreatitis eight months back. Physical examination revealed tenderness in epigastrium and umbilical region without any sign of peritonitis while other vital parameters were within a normal limit. Laboratory findings (CBC, LFT, KFT, amylase and lipase) were within normal limits. Ultrasonography was apparently normal. CECT abdomen showed jejunal diverticulitis with surrounding haziness and fat stranding along with small mass formation by surrounding omentum and jejunal loops with multiple jejunal diverticuli [Table/Fig-1-3].
Journal of clinical and diagnostic research : JCDR, 2017
Malrotation of the midgut is generally regarded as a paediatric pathology. It is rare in adults. ... more Malrotation of the midgut is generally regarded as a paediatric pathology. It is rare in adults. Patients may present with symptoms of acute bowel obstruction or chronic abdominal pain. Barium study, Contrast Enhanced Computed Tomography (CECT), Magnetic Resonance Imaging (MRI), diagnostic laparoscopy and sometimes explorative laparotomy are used for diagnosis. Ladd's procedure through the open approach has been the treatment of choice for complete malrotation of midgut, however there are reports on successful outcome for both complete and incomplete malrotation after laparoscopic approach as well. We report a case of a 25-year-old female who presented with a history of severe pain in abdomen for one week. CECT abdomen showed incomplete malrotation and volvulus in midgut. Laparoscopic detorsion of bowel loops, adhesiolysis, caecopexy and appendectomy was done. Patient's symptoms subsided immediately after surgery. Histological analysis of the appendix specimen showed small a...
Apollo Medicine, 2017
Introduction: Bowel obstruction occurs when the normal flow of intraluminal content is interrupte... more Introduction: Bowel obstruction occurs when the normal flow of intraluminal content is interrupted. The most common cause of small bowel obstruction is adhesion but other rare causes of intestinal obstruction have also been reported as fecolith, foreign body or bezoar, GIST, and abdominal cocoon. Laparoscopy as diagnostic as well as therapeutic tool in small bowel obstruction seems to be useful. Methods: We described two rare causes of intestinal obstruction. The aim of the present article is to stress the role of laparoscopy associated with computed tomography (CT) in diagnostic confirmation of causes of intestinal obstruction as well as reasons for conversion. We also reviewed the relevant published literature. Result: CASE 1: A 63-year-old female presented with history of recurrent episodes of pain in left side of abdomen for 1 year. Contrast Enhanced Computed Tomography (CECT) showed rounded radiopaque foreign body in distal jejunum. Laparoscopic adhesiolysis and reduction of hernial content were done. Laparoscopic surgery converted to open for removal of foreign body and hernioplasty. CASE 2 64 year elderly male presented with history of intermittent episodes of colicky pain in periumbilical region for 1 month. CECT abdomen showed abdominal cocoon. Pneumoperitoneum access was not succeeded, thus exploratory laparotomy and adhesiolysis was done. Conclusion: In small bowel obstruction, diagnostic laparoscopy has to be done for confirmation of diagnosis and if possible to release the cause of obstruction, but conversion to open by giving either small incision or exploratory laparotomy should be the choice to completely remove the cause for the further prevention of recurrence and complications.
Journal of Medical Science And clinical Research, 2018
Introduction: In the present study investigated the laparoscopic management of gastric GIST in va... more Introduction: In the present study investigated the laparoscopic management of gastric GIST in various locations in stomach. Method: This study was retrospective review of all GIST patients admitted between Oct2015-Jan 2018 in our institute Fortis Memorial Research Institute were analysed. Patients demographics, clinical presentation, tumour characteristics, radiological, pathological and immunohistochemical findings, techniques of laparoscopic resection, recurrence , postoperative outcome were analysed. Result: Total 18 patients were taken for laparoscopic excision of GIST tumor of these 16 patients were excised laparoscopically and 2 converted to open partial gastrectomy. In total of 16 patients, 13 patients resected laparoscopically and 3 patients were converted to open. Conclusion: GIST larger than 5 cm should not be contraindication for laparoscopic resection but may require open surgery.
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Papers by PRIYANKA TIWARI