Gastrointestinal & Colorectal Surgery

Right iliac fossa mass in a female, 42 years.
The patient presented with pain and lump in right iliac fossa, distension of abdomen, vomiting and loss of appetite. CEA, CA-125 and serum ADA were within normal limits. USG abdomen and CT Scan of abdomen revealed a mass in the right iliac fossa.
 


On exploration a right iliac fossa mass formed by amalgamation of right ovary, uterine tube, adenexa, rectum and vermiform appendix was seen. Rectal involvement has caused stricture of upper rectum. Enbloc removal of the mass with multivisceral resection was done. [ Low anterior resection, total hysterectomy and appendicectomy.] Reconstruction was done with primary colorectal anastomosis.
Rectal Stricture
































Sigmoid colon mass in a 40 yr female: On exploration the mass was infiltrating uterine adnexa, urinary bladder and parietal wall. En-bloc multivisceral resection was done. Sigmoid colon, left adnexa and parietal wall resection along with partial cystectomy was done. Histopathology revealed adenocarcinoma of sigmoid colon.

Cancer sigmoid colon

A rare case of Colocolic intussusception in a 60 yrs female: CEA was 24 mcg/L. An extended right hemicolectomy with stapled side to side ileocolic anastomosis was performed.  







Carcinoma descending colon with transverse colostomy prolapse in a 75 yr male:  Pancolectomy with primary ileorectal anastomosis was performed.. Histopathology revealed adenocarcinoma of descending colon.



Sigmoid Volvulus in a bedridden 65 yrs female patient: Sigmoid colectomy with triple stapled colorectal anastomosis was performed.




Adenocarcinoma of Caecum:

 
 
 
 

Hirschsprung's disease in adulthood: Nineteen year male with complains of severe constipation since childhood. CT scan and contrast studies revealed dilated colon with coning in distal sigmoid colon and collapsed rectum.


Hirschsprung's disease in adult





Internal hernia through a congenital mesenteric defect:











Stapled hemorrhoidopexy ( MIPH/ PPH)          



Stapled hemorrhoidopexy

Postoperative view after stapled hemorrhoidopexy:

  




Fourth degree hemorrhoids: Stapled hemorrhoidopexy done 



 
 
 
 
 
 
 
 
 
 

Foreign body rectum:  PVC pipe  in sigmoid colon retrieved per anum 

 This patient inserted about 52 cm PVC pipe per anum. On imaging PVC pipe was found twisted in the sigmoid colon. Exploratory Laparotomy was done to retrieve the PVC pipe.