Many were embedded in the bladder wall and in the prostatic urethra
and were quite difficult to scrape out. Some of the stones were hard
and some were mushy. He previously had had a suprapubic
prostatectomy somewhere and since then he has passed some fairly large
stones in his urine that he showed me. Probably a result of
schistosomiasis which is very common here.
Another one was a 17-yr girl with bowel obstruction saying she had not
passed any stool for 3 weeks. She had a palpable soft mass in mid
abdomen that percussed to be hollow. It was not tender and she did
not complain of pain. Echo just showed a lot of gas in the abdomen.
So we did a laparotomy and found what appeared to be a
retroperitoneal mass being that we had two lymphomas retroperitoneal
that were unresectable the previous day. I kept exploring around
this mass and found that small intestine went into it and that the
colon was empty and found the cecum and appendix were normal as I
worked them out of this mass. Was able to free the final 15 cm of
terminal ilium but still had this thing that was thickened around a
loop of intestine. Some of the intestine felt like intussiception
or a soft mass in the lumen maybe. Finally was able to resect about
25 cm of small intestine (ilium) and reconnect it together Even
after surgery and examining the specimen still not sure what caused
the pathology and obstruction. It definitely was not a classic
intussiception. No evidence was found of abcess or infection.
Whatever it was it was taken out although I had almost closed her with
doing nothing at the beginning but something prompted me to keep
trying to find out the problem and keep probing and try to help the
girl. The spinal anesthetic ran out before finished and she had a
reaction to diazepam or fentanyl and quit breathing for a time just
as she was closed but thankfully no heart problem and was able to get
her going again. Thankful for Olen that came over to help when called. I'll be glad
when our anesthetist gets here in June.
passed any stool for 3 weeks. She had a palpable soft mass in mid
abdomen that percussed to be hollow. It was not tender and she did
not complain of pain. Echo just showed a lot of gas in the abdomen.
So we did a laparotomy and found what appeared to be a
retroperitoneal mass being that we had two lymphomas retroperitoneal
that were unresectable the previous day. I kept exploring around
this mass and found that small intestine went into it and that the
colon was empty and found the cecum and appendix were normal as I
worked them out of this mass. Was able to free the final 15 cm of
terminal ilium but still had this thing that was thickened around a
loop of intestine. Some of the intestine felt like intussiception
or a soft mass in the lumen maybe. Finally was able to resect about
25 cm of small intestine (ilium) and reconnect it together Even
after surgery and examining the specimen still not sure what caused
the pathology and obstruction. It definitely was not a classic
intussiception. No evidence was found of abcess or infection.
Whatever it was it was taken out although I had almost closed her with
doing nothing at the beginning but something prompted me to keep
trying to find out the problem and keep probing and try to help the
girl. The spinal anesthetic ran out before finished and she had a
reaction to diazepam or fentanyl and quit breathing for a time just
as she was closed but thankfully no heart problem and was able to get
her going again. Thankful for Olen that came over to help when called. I'll be glad
when our anesthetist gets here in June.
Also saw a man today with some some kind of skin condition that he had
since birth. It look almost like grapes or condylomata or ? all over
his neck and on one side of his face. It is painless and has no
drainage from it. I don't know what it is but I may eventually try
to remove it and put on a skin graft perhaps after our anesthetist
gets here.
since birth. It look almost like grapes or condylomata or ? all over
his neck and on one side of his face. It is painless and has no
drainage from it. I don't know what it is but I may eventually try
to remove it and put on a skin graft perhaps after our anesthetist
gets here.
Mar 21 We had another ruptured uterus with a dead baby. Mother
had had 11 previous pregnancies so why did she not progress ? Did
she get some IM oxytocin at the "health center" before coming here?
We usually can not get good histories. I also took out a
intramedullary rod SIGN that was put in last June. The man had
chronic osteomyletis. His original injury was a very bad fracture of
femur, tibia-fibula and knee from a moto accidents. It had been
suggested that removing the rod might help get rid of the osteo. I
don't know if it will help or not.
had had 11 previous pregnancies so why did she not progress ? Did
she get some IM oxytocin at the "health center" before coming here?
We usually can not get good histories. I also took out a
intramedullary rod SIGN that was put in last June. The man had
chronic osteomyletis. His original injury was a very bad fracture of
femur, tibia-fibula and knee from a moto accidents. It had been
suggested that removing the rod might help get rid of the osteo. I
don't know if it will help or not.
The weather is warming up as it is 107 where we have pot lucks and 98
in the house but they say it will get warmer in April.
Dolores is still doing mangoes to can and to dry.
in the house but they say it will get warmer in April.
Dolores is still doing mangoes to can and to dry.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Love Rollin and Dolores
Love Rollin and Dolores
