Modified Glasgow-Imrie Score Severe pancreatitis likely: 3 or more of the following within 48 hours of symptom onset Mnemonic: PANCREAS Mnemonic Criteria Positive when P PaO2 <60 mmHg A Age >55 years N Neutrophils (WBC) >15,000/cu.mm C Calcium <2 mmol/l R RFT (Urea) >16 mmol/l E Enzyme (LDH/AST) LDH >600…
Tag: General Surgery
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Epiploic foramen of Winslow : Mnemonic
Epiploic foramen is a vertical opening through which lesser sac (omental bursa) communicates with the greater sac (peritoneal cavity proper). It is at the level of T12 vertebra. Boundaries Mnemonic: Epiploic foramen is located between CD and HI. Superior: Caudate process of liver Inferior: Duodenum (1st part) Anterior: Hepatoduodenal ligament…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Interpretation of NCCT head: Normal findings
History: In 1972, Sir Godfrey Hounsfield developed CT scan for which he was awarded Nobel prize in 1979. Through these years CT has come from one rotation in 6 minutes to one in 0.33 seconds. Principle: X rays are produced by CT machine, which are absorbed by different tissues in…
Case Reports 
A case of EA/TOF (esophageal atresia/tracheoesophageal fistula)
Case summary A female neonate was born via emergency cesarean section at 36 weeks of gestation. The indication of LSCS was polyhydramnios with fetal bradycardia. The birth weight of the neonate was 1700 grams following which the baby was shifted to NICU for observation. I, as a surgical resident was…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Gastrointestinal Stromal Tumor (GIST) : A Comprehensive Review
Introduction: Other facts: Clinical features: Diagnosis: Role of biopsy/tissue diagnosis in GIST (current consensus): Treatment: High risk features: Choices of surgery: Aim of surgery: Prognostication: Malignant potential Comments Mortality Benign Size: up to 2 cmMitosis: up to 5/50 hpf No tumor related mortality Probably benign Size: 2-5 cmMitosis: same as…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Surgical Anatomy of Diaphragm
Diaphragm is a thoracoabdominal organ which is musculotendinous. It is the primary muscle of respiration. Extension: There are 2 crura of diaphragm: 3 ligaments: Quadratus lumborum muscle is related to lateral arcuate whereas psoas muscle is related to medial arcuate ligament. The foramen of Morgagni shown in the above picture…
Clinical Skills and Approaches 
An approach to Abdominal Trauma
Abdominal Trauma Abdominal trauma can be broadly classified into: Both of these have different approach of management. In case of any trauma, you need to go serially as per ATLS guidelines, i.e., the primary survey followed by the secondary survey. For quick recap, primary survey includes: Note: according to ATLS,…
Case Reports 
A Complication following vasectomy and its management
Case Summary A 45-year male presented to emergency with complaints of pain and swelling over scrotum for 10 hours (at around 11:00 pm). Upon further inquiry he had undergone vasectomy (no scalpel) at a local health post camp at around 1 pm on the same day. He had no known…