Papers by Anbalagan Pichaimuthu
International Journal of Allied Medical Sciences and Clinical Research, 2019
Spontaneous esophageal perforation; Boerhaave Syndrome; conservative treatment of esophageal perforation
Journal of evolution of medical and dental sciences, Nov 5, 2015
Anaphylaxis to oral PEG. BACKGROUND: Mechanical Bowel preparation (MBP) is commonly practised for... more Anaphylaxis to oral PEG. BACKGROUND: Mechanical Bowel preparation (MBP) is commonly practised for patients prepared for major abdominal surgeries and colonoscopies. Patients with periampullary tumour planned for pancreaticoduodenectomy had their bowel prepared the day before surgery. The importance of this case report is to highlight the rarest of complications of a seemingly innocuous and commonly performed procedure CASE REPORT: A 47 year old female, a case of periampullary carcinoma with no comorbid illness, was planned for pancreaticoduodenectomy. She had features of obstructive jaundice with cholangitis for which endoscpoc biliary stenting was done. Following consumption of oral PEG solution the day before surgery, patient developed rash, hypotension and breathing difficulty which necessitated ICU admission and postponement of proposed surgery. CONCLUSION: Our case highlights a rare but potentially life threatening adverse reaction to PEG solutions. A greater awareness of this rare complication is essential for the treating physicians to effectively manage this entity.
Journal of evolution of medical and dental sciences, Oct 29, 2015
Spontaneous Oesophageal perforation is lethal unless managed appropriately. Oesophageal perforati... more Spontaneous Oesophageal perforation is lethal unless managed appropriately. Oesophageal perforation can be spontaneous (Boerhaeve), post traumatic, malignant or foreign body induced. Appropriate treatment depends on the size of perforation, time of presentation between rupture and diagnosis and general condition of the patient. Not all patients need surgical management and when carefully selected there are subset of patients who can be managed medically. CASE REPORT: A case of spontaneous oesophageal perforation due to intense retching following alcohol intake in a 35year old male is described here with a review of pertinent literature. The patient had presented with intense retching followed by vomiting which contained undigested food particles initially only to be followed by hematemesis, chest pain, fever with left sided pleural effusion. Computed tomographic scan demonstrated a pneumomediastinum, and left sided pleural effusion. The patient was managed successfully by conservative treatment. CONCLUSION: Spontaneous oesophageal perforation can be managed conservatively in a selected set of patients.
Journal of Minimal Access Surgery, 2021
Endoscopic profile of acute upper gastrointestinal bleed in adults: A tertiary care center-based study in South India
Journal of Datta Meghe Institute of Medical Sciences University, Apr 1, 2021
Unusual Cause of GI Bleed—Ectopic Pancreas
Indian Journal of Surgery, 2021
Ectopic pancreas is typically asymptomatic anomaly that can present anywhere along the GI tract. ... more Ectopic pancreas is typically asymptomatic anomaly that can present anywhere along the GI tract. It is often found incidentally and may become clinically evident when complicated by inflammation, bleeding, obstruction, or malignant transformation. Here, we present a case of ectopic pancreas who presented with gastrointestinal bleeding.
Journal of Evolution of medical and Dental Sciences, 2015
Anaphylaxis to oral PEG. BACKGROUND: Mechanical Bowel preparation (MBP) is commonly practised for... more Anaphylaxis to oral PEG. BACKGROUND: Mechanical Bowel preparation (MBP) is commonly practised for patients prepared for major abdominal surgeries and colonoscopies. Patients with periampullary tumour planned for pancreaticoduodenectomy had their bowel prepared the day before surgery. The importance of this case report is to highlight the rarest of complications of a seemingly innocuous and commonly performed procedure CASE REPORT: A 47 year old female, a case of periampullary carcinoma with no comorbid illness, was planned for pancreaticoduodenectomy. She had features of obstructive jaundice with cholangitis for which endoscpoc biliary stenting was done. Following consumption of oral PEG solution the day before surgery, patient developed rash, hypotension and breathing difficulty which necessitated ICU admission and postponement of proposed surgery. CONCLUSION: Our case highlights a rare but potentially life threatening adverse reaction to PEG solutions. A greater awareness of this rare complication is essential for the treating physicians to effectively manage this entity.
International Journal of Advances in Medicine
Pancreaticopleural fistula is a very rare complication of acute and chronic pancreatitis. High in... more Pancreaticopleural fistula is a very rare complication of acute and chronic pancreatitis. High index of suspicion is needed to diagnose in patients with alcohol induced pancreatitis, presenting with recurrent or persistent pleural effusion. Patient typically presented with pulmonary symptoms, rather than abdominal complaints, leading to delay in the diagnosis. Here we present a case of a known chronic pancreatitis who presented to us with massive left sided pleural effusion. Blood coloured pleural fluid analysis showed lipase and amylase levels in hundred thousand and ten thousand ranges. Diagnosis was made by CECT abdomen and confirmed with MRCP. Patient was treated with first line medical management of thoracocentesis and ERCP with pancreatic duct stenting.
Journal of Evolution of Medical and Dental Sciences, 2015
Spontaneous Oesophageal perforation is lethal unless managed appropriately. Oesophageal perforati... more Spontaneous Oesophageal perforation is lethal unless managed appropriately. Oesophageal perforation can be spontaneous (Boerhaeve), post traumatic, malignant or foreign body induced. Appropriate treatment depends on the size of perforation, time of presentation between rupture and diagnosis and general condition of the patient. Not all patients need surgical management and when carefully selected there are subset of patients who can be managed medically. CASE REPORT: A case of spontaneous oesophageal perforation due to intense retching following alcohol intake in a 35year old male is described here with a review of pertinent literature. The patient had presented with intense retching followed by vomiting which contained undigested food particles initially only to be followed by hematemesis, chest pain, fever with left sided pleural effusion. Computed tomographic scan demonstrated a pneumomediastinum, and left sided pleural effusion. The patient was managed successfully by conservative treatment. CONCLUSION: Spontaneous oesophageal perforation can be managed conservatively in a selected set of patients.
International Journal of Surgery, 2014
This study evaluates the feasibility of implementing fast-track surgery in pancreaticoduodenectom... more This study evaluates the feasibility of implementing fast-track surgery in pancreaticoduodenectomy with pancreaticogastrostomy. The study is a prospective study with historical control. There are very few studies on fast-track surgery in pancreatic resections. The few studies published are from centres which perform pancreaticojejunostomy for reconstruction.
Feasibility of implementing fast-track surgery in pancreaticoduodenectomy with pancreaticogastrostomy for reconstruction – A prospective cohort study with historical control
International Journal of Surgery, 2014
Fast track programmes have been introduced in pancreatic surgery, but the data are sparse. The ai... more Fast track programmes have been introduced in pancreatic surgery, but the data are sparse. The aim of this prospective study was to analyse the feasibility of implementing fast track rehabilitation protocol in PD with pancreaticogastrostomy, using historical control for comparison. Between April 2012 and December 2012, twenty patients who underwent PD (with pancreaticogastrostomy) were managed by a fast-track rehabilitation protocol. These patients were compared with an equal number of historical controls treated according to the traditional protocol. Patients in the fast track group were able to tolerate liquid (p = 0.0005) and solid diet (p = 0.0001) earlier, and they passed stools earlier (p = 0.02). Delayed gastric emptying (DGE) was significantly reduced in the fast track group (p = 0.02). There was no difference in the rates of pancreatic fistula (PF), post pancreatectomy haemorrhage (PPH) and mortality between the two groups. Length of hospital stay was reduced in the fast track group (median 14 vs 18.5, p = 0.007). Fast track programme appears to be feasible in PD, even with pancreatico-gastric anastomosis. It is associated with early recovery, reduced DGE and reduced hospital stay.
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Papers by Anbalagan Pichaimuthu