Copy of Copy of 4 New.pptx 11111

8/8/2019 Copy of Copy of 4 New.pptx 11111

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AUDIT

28th Nov _ 03th Dec 2010-


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Admissions

Total _ 44

Routine 08

Casualty 28

Ex- ward _ 03

Transfer in-01

Transfer out-01 deaths -0


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Surgeries - 9

Incisional Herniotomy -2

Open cholecystectomy -1

Nephrolithotomy -1

Hydrocelectomy -1

Thyroidectomy -1

Mastectomy -1

Colonis transposition -1

I and D -1


4/31

Mrs Haputhanthri 43 years

Underwent L/ ureterolithotomy 2007

3 years following operation developed bulging ofthe L/s lower abdominal wall

On and off abdominal pain No features of intestinal obstruction

PMHx -Type 2 Diabetes

O/E -L/s Incisional Hernia

Herniotomy and Mesh Repair

On post op Day 3


5/31

Mr U.Withana 57yrs

Underwent appendicectomy at age 12

Had developed a surgical site infection

Developed a lump over the surgical scar since1 year and gradually increased in size

Developed intestinal obstruction 1 month ago

O/E - R/s Irreducible Incisional Hernia

Incisional herniotomy and mesh repair done

On post op Day 3


6/31

Mrs T.A.I.Peiris 40yrs

Presented with Epigastric pain ,fever andvomiting for 3 days

Treated with IV antibiotics

Transferred from a medical ward

O/E -febrile

R/Hypochondriac and epigastric

tendernessHepatomegali

USSAbdomen - Multiple gallstones with acutecholecyctitis


7/31

Findings - Inflamed gallbladder with

empyema

Gallbladder adhere to adjacent

structures

Sub total cholecystectomy done

On post op Day 3


8/31

Mr.J.N.Fernando 42 yrs

Recurrent R/s ureteric colics for 6 years

No haematuria or other urinary symptoms

2005 underwent R/s pyelolithotomy

CT scan of abdomen R/s Hemi staghorn calculiinvolving renal pelvis,mid and lower calyces

No evidence of obstruction

R/s Nephrolithotomy doneOn post op day 3


9/31

Mr.R.M.C.Ratnayake 45 yrs

R/ S scrotal swelling 5yrs

On and off mild pain

Significantly increase in size O/E R/s Hydrocele

Hydrocelectomy done

On post op D1


10/31

Mrsiss N.H.Sumanasiri(28y)

Recurrence of Goitre

Underwent R/s hemithyroidectomy in 2005

Recurred goitre after 3 years Clinically and biochemically euthyroid

Multinodular goitre

No retrosternal extention

No features of malignancy Xray neck-trachea narrowed shifted to the left

FNAC - colloid goitre


11/31

L/s hemithyroidectomy done

Specimen sent for histology


12/31

Mrs.G.G.De Soyza(58yrs)

Initially had developed L/s blood stainednipple discharge

L/s breast lump 6 yrs

O/E 2 hard breast lumps on L/upperquadrants

No axillary lymphadenopathy T3 L0 M0

FNAC Duct carcinoma


13/31

L/s mastectomy done

Specimen sent for histology


14/31

Mrs P.N.Damayanthi(20yrs)

Returned from Jordan

On 5 th November had ingested a corrosivesubstance

Following that developed peritonitis

Midline laparotomy done on 12 th of November

Findings - Perforation of lower oesophagus

Perforations of greater curvature,at fundus andpylorus

Gangrenous stomsch

Near total gasterctomy done


15/31

The part of lesser curvature exteriorized as a fistula

Pyloric stump closed

Feeding jejunostomy insterted

Ix Total protein - 6.4

Albumin -3.3

Hb -9.3

High protein liquid diet 2 units of blood transfused

Chest physiotherapy

Bowel preparation


16/31


17/31

Mr.D.P.Kumarasinghe (55yrs)

Dysuria and frequency 3 days

Urinary retention

No fever No haematuria

UFR - red cells moderately field ful

Serum creatinine -rising (126-163)

USSAbdomen

Large stone in a bladder diverticulum

Bilateral hydronephrosis


18/31

Casualty admissions

Ureteric colics (10) Mr W.P.DeSilva (43y)

Mr H.R.Rajapakse (63y)

Mr R.L.Gunawardana (44y)

Mrs Botheju (51y)

W.A.Chandrasiri (34y)

Mr K.L.Gunawardana (44y)

Mr M.R.somqrathne (30y) Mrs P.M.Sumanawathi (57y)

Mr D.A.Samantha (25y)

MrS.W.Kumara (36y)


19/31

Abdominal pain

Mrs N .Subashini(27yrs)

RIF pain 1 day

MissT.Dayarathne (24 yrs)Paraumbilical pain 1 day

USSAbdomen Normal

Mr R.Rajapakse (63 yrs)

Abdominal discomfort 2 daysNo vomiting

Constipation


20/31

Mr H.Padmasiri (30yrs)

Recurrent fever and R/s loin pain 2 monyhs

No urinary symptoms

O/E R/s renal angle tendernessFBC - WBC - 15000

UFR - Normal

USSAbdomen - R/S pyelonephritisOn Iv Amikacin


21/31

Mrs B.Abesekara (79yrs)

Transferred from ward 17

Treated for vertigo

On and off PR bleeding due to haemorrhoids4 yrs

Managing conservatively


22/31

Mrs R.Chandrani (56yrs)

Diagnosed patient with Osteo arthritis and

varicose veins

Sudden onset R/ leg pain while walking


23/31

Mr Surendra (40y)

R/s loin pain radiate along R/ lower limb 3

days

Backache 4 years

O/E Bilateral SLRT positive

Transferred to orthopaedic ward


24/31

Mr D.C.rathnayake(45yrs) PainfulScrotal lump 3 day

No fever

O/E evolving abscess of L/s of scrotum Spontaneously ruptured

Miss N.Dilhani (26yrs) Pilonoidal abscess 3 days

Mr D.Abeywardana(57yrs)

Abscess in the L/thigh

Recently diagnosed Diabetes


25/31

Mr A. Warnarathne (65yrs)

Infected sebaceous cyst on the L

hemiscrotum 5 days I and D done


26/31

Cellulitis.

1. Mr. W.A. Pushpakumara (30yrs)

2. Mrs. C.H.D. Leelawathi (78yrs)

3. Mr.Keerthirathna(50yr)

Mrs D.A.Nandawathi (76yrs)

Chronic wound on the R/foot 1 year


27/31

Mrs S.Samarajeewa (39yrs)

Pinful defecation and on and off rectal

bleeding 6 months

Diagnosed to have anal fissure Laxatives given


28/31

Mrs S.Wijesundara (52yrs)

Underwent incisional herniotomy on 18 th

november

Developed a low grade fever on 12 th postoperative day

Discharged large amount of pus from the

surgical site

On IV antibiotics


29/31


30/31

RTA

Mr H.Suranga (29 yrs)

Backache and neck pain

Mr K. Rangana (27 yrs)

Contusion and laceration of L/ arm


31/31

Thank you.

Documents

Copy of Copy of 4 New.pptx 11111