Dr.Vidushi Jain

Professionnnal Qualification

MBBS , MS , FIART

SPECIALITIES

Dpt. of Gynecology & Obstetrics

Dpt. Of Infertility Fertility & Reproductive Medicine

The Department of Gastrointestinal Surgery features a highly experienced team of gastrointestinal and pancreatic surgeons. Emergency cases are handled round the clock through Casualty.

This department has a comprehensive surgical program focusing on

  • Advanced Laparoscopic Surgical Procedures.
  • Oncological Surgery of the GI Tract.
  • Pancreatico-Biliary Surgery.
  • Specialized Colorectal Surgery
  • Stapled and Pouch Procedures.
  • Gastric and Oesophageal Surgery.
  • Intra-Abdominal Vascular Reconstruction
  • Retroperitoneal Tumour Excisions.
  • Intra-Abdominal Trauma.

Laparoscopic Surgeries

It is also known as minimally invasive surgery. Laparoscopic surgery is performed for the operations of the abdomen with 6 to 12 inch long cuts. Surgery done through one or more small incisions, using small tubes and cameras and surgical instruments was one of the first types of minimally invasive surgery

We specialize in various kinds of Laparoscopic surgeries. Some of them are mentioned as follows–

  • Laparoscopic Cholecystectomy
  • Laparoscopic common bile duct exploration for stone disease
  • Laparoscopic Appendicectomy
  • Laparoscopic Hernia Repair
  • Diagnostic laparoscopy for the evaluation of obscure abdominal symptoms, pain or ascites
  • Laparoscopic Assisted Colorectal Resections for Cancer
  • Laparoscopic Liver Surgeries for Cystic Diseases of the liver
  • Laparoscopic Directed Small Bowel Surgeries
  • Laparoscopic Myotomy for Achalasia Cardia
  • Laparoscopic Splenectomy
  • Laparoscopic Cysto-Gastrostomy
  • Laparoscopic Bariatric Surgery

Gall Bladder

The gallbladder is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver .It receives and stores bile, produced by the liver, via the common hepatic duct, and releases it via the common bile duct into the duodenum, where the bile helps in the digestion of fats .The gallbladder is part of the biliary system, which includes the liver and the pancreas. The gallbladder can be affected by gallstones, formed by material that cannot be dissolved.The presence of stones in the gallbladder is referred to as cholelithiasis.

What Are Gallstones?

Gallstones are “stones” that form in the gallbladder . The common types of gallstones are cholesterol, black pigment, and brown pigment.

The two main kinds are:

Cholesterol stones: These are usually yellow-green in color. They’re the most common kind, accounting for 80% of gallstones.

Pigment stones: These stones are smaller and darker. They’re made up of bilirubin, which comes from bile, a fluid your liver makes and your gallbladder stores.

What Causes Gallstones?

Gallstones may form when the chemicals in the gallbladder are out of balance, such as cholesterol, calcium bilirubinate, and calcium carbonate.

Am I at Risk?

You’re more likely to get gallstones if:

  • You’re obese. This is one of the biggest risk factors. Obesity can raise your cholesterol level and also make it harder for the gallbladder to empty completely.
  • You take birth control pills, hormone replacement therapy for menopause symptoms, or are pregnant.
  • The extra estrogen is the problem. It can increase cholesterol and make it harder for the gallbladder to empty.
  • You have diabetes. People with this condition tend to have higher levels of triglycerides (a type of blood fat), which is a risk factor for gallstones.
  • You take medicine to lower your cholesterol. Some of these drugs boost the amount of cholesterol in bile, which may increase your chances of getting cholesterol stones.
  • You lost weight too quickly. Your liver makes extra cholesterol, which may lead to gallstones.
  • You’re fasting. Your gallbladder may not squeeze as much
  • Gallstones are also more likely if they run in your family, and they’re likelier among women, older people, and some ethnic groups, including Native Americans and Mexican-Americans.

What Are the Symptoms?

You might not notice anything, or even know you have gallstones, unless your doctor tells you. But if you do get symptoms, they usually include:

  • Pain in your upper belly and upper back that can last for several hours
  • Nausea
  • Vomiting
  • Other digestive problems, including bloating, indigestion and heartburn, and gas.

Asymptomatic gallstones

  • Gallstones themselves don’t cause pain. Rather, pain occurs when the gallstones block the movement of bile from the gallbladder.
  • How Do Doctors Diagnose Them? If your doctor thinks you may have gallstones, he’ll give you a physical exam. You may also get: Blood tests to check for signs of infection or obstruction, and to rule out other conditions.
  • Ultrasound. : An ultrasound produces images of your abdomen. It’s the preferred imaging method to confirm that you have gallstone disease. It can also show abnormalities associated with acute cholecystitis
  • Abdominal CT scan. Specialized X-rays allow your doctor to see inside your body, including your gallbladder.
  • Magnetic resonance cholangiopancreatography (MRCP) is a medical imaging technique that uses magnetic resonance imaging to visualize the biliary and pancreatic ducts in a non-invasive manner.This procedure can be used to determine if gallstones are lodged in any of the ducts surrounding the gallbladder.
  • Cholescintigraphy (HIDA scan). This test can check on whether the gallbladder squeezes correctly. Doctors inject a harmless radioactive material, which makes its way to the organ. The technician can then watch its movement.
  • Endoscopic ultrasound. This test combines ultrasound and endoscopy to look for gallstones.
  • Endoscopic retrograde cholangiopancreatography (ERCP). The doctor inserts an endoscope through your mouth down to the small intestine and injects a dye to allow the bile ducts to be seen. He can often then remove any gallstones that have moved into the bile duct.

What’s the Treatment?

  • Many people with gallstones get surgery to take out the gallbladder. There are two different kinds of operations.
  • Laparoscopic cholecystectomy. This is the more common procedure. The surgeon passes instruments, a light, and acamera through several small cuts in the abdominal cavity. He views the inside of the body on a video monitor. Afterward, you spend the night in the hospital.
  • Open cholecystectomy. The surgeon makes bigger cuts in the belly to remove the gallbladder. You stay in the hospital for a few days after the operation. If gallstones are in your bile ducts, the doctor may use ERCP to find and remove them before or during gallbladder surgery. Can You Treat Gallstones Without Surgery? If you have a medical condition and your doctor feels you shouldn’t have an operation, he may prescribe the medications chenodiol (Chenix), ursodiol (Actigall), or both. These drugs work by dissolving cholesterol stones. Mild diarrhea can be a side effect.

Complication of Gall Bladder Stone :

  • Inflammation of gall bladder ( Acute Cholecystitis) Jaundice.
  • Infection of the bile ducts (Acute cholangitis)
  • Acute pancreatitis
  • Cancer of the gallbladder
  • Gallstone ileus

What is the appendix?

The suffix “-itis” means inflammation, so appendicitis is inflammation of the appendix. Appendicitis occurs when mucus, stool, or a combination of the two blocks the opening of the appendix that leads to the cecum. Bacteria proliferate in the trapped space and infect the lining of the appendix. If the inflammation and blockage are severe enough, the tissue of the appendix can die and even rupture or burst, leading to a medical emergency.

Who is affected by appendicitis

Anyone can get appendicitis, but it occurs most often in people between the ages of 10 and 30. Very young children and elderly people are at higher risk of complications due to appendicitis. Early recognition and prompt treatment of the condition are necessary, especially in vulnerable populations.

What are the most frequent complications of appendicitis

Delaying the diagnosis and treatment of appendicitis increases the risk of complications. One potential complication — perforation — can lead to an accumulation of pus (abscess) around the appendix or an infection that spreads throughout the abdominal cavity (peritonitis). Surgery should occur as soon as possible after the diagnosis of appendicitis. Longer delays between diagnosis and treatment (surgery) increase the risk of perforation. For example, the risk of perforation 36 hours after appendicitis symptoms first appear is 15% or more.

What is another complication of appendicitis?

Sometimes the inflammation associated with appendicitis interferes with the action of the intestinal muscle and prevents bowel contents from moving. Nausea, vomiting, and abdominal distention can occur when liquid and gas build up in the part of the intestine above the blockage. In these cases, the insertion of a nasogastric tube — a tube that is inserted into the nose and advanced down the esophagus into the stomach and intestines — may be necessary to drain the contents that cannot pass.

What are the symptoms of appendicitis?

The presentation of acute appendicitis includes abdominal pain, nausea, vomiting, and fever. As the appendix becomes more swollen and inflamed, it begins to irritate the adjoining abdominal wall. This leads to the localization of the pain to the right lower quadrant. This classic migration of pain may not be seen in children under three years. This pain can be elicited through signs and can be severe. Signs include localized findings in the right iliac fossa. The abdominal wall becomes very sensitive to gentle pressure (palpation). There is severe pain on sudden release of deep pressure in the lower abdomen (rebound tenderness). If the appendix is retrocecal (localized behind the cecum ), even deep pressure in the right lower quadrant may fail to elicit tenderness (silent appendix). This is because the cecum , distended with gas, protects the inflamed appendix from pressure. Similarly, if the appendix lies entirely within the pelvis, there is usually complete absence of abdominal rigidity. In such cases, a digital rectal examination elicits tenderness in the rectovesical pouch. Coughing causes point tenderness in this area ( McBurney’s point ), historically called Dunphy’s sig

How is appendicitis diagnosed?

Doctors diagnose appendicitis based on the patient’s symptoms and findings during physical examination.

  • Clinical
  • Blood and urine test
  • Ultrasound
  • Computed tomography
  • How is appendicitis treated?
  • Surgical removal of the appendix is called an appendectomy. Antibiotics are given to a patient with suspected or confirmed appendicitis both before and after surgery. Appendectomy can be performed laparoscopically.