16 years old female with pain abdomen 6 months duration. On investigations USG followed by CECT abdomen reveals CHOLELITHIASIS Ectopic malrotated kidney A large intra abdominal cystic lesion 13 cm (CC) × 8.4 cm (AP) × 9.2 cm (TR) Management Protocol- welcomed

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Exploratory laparotomy is the only answer & than decide on table sir
For abdominal cyst i would suggest USG guided FNA then definative treatment... For cholelithiasis if stones are more than 1 cm and are symptomatic then better to do lap cholecystectomy... Nothing to be done for malroatated kidney.. I would suggest during lap cholecystectomy confirm the diagnosis of intraabdominal cyst also and take decision for the same...
Hello Nice case involving multiple systems.. Abdominal cyst - More likley Mesenteric cyst Cholelithiasis with Thickened wall.. possibility of Past History of Cholecystitis.. Malroatated kidney - Not a concern.. Plan : Laparotomy or Laparoscopic Cyst Excision and cholecystectomy
suggested ...1)no intervention for the ectopic kidney presently. 2) Lap cholecystectomy . 3) During the course of Lap chole, we could jolly well have a look at the cyst &once sure where from the cyst is rising from... ? Pancreas ? Mesentery or Ovaries? &then probab. we could finally decide whether an intraabdominal surgery is indicated./ or lap.cystectomy !! Thnx !! Regards to all.
It is a complicated case. Is the girl running fever, if febrile indicates Septicemia.So do aspiration of the abdominal fluid & send the fluid for C/ S . Start appropriate Antibiotic preferably Inj.Meripanum Inj. Of loxin with Ornidazole bid for 7_ 10 days.
Afebrile- Only complaint is recurrent abdominal pain
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Thorough evaluation of lungs Lap cholycystectomy with diagnostic laproscopy And laproscopic cystostomyor malsuplization can be done. If possible first discuss with the radiologist or take a second openion on ct scan.
In ectopic kidney first of rule out status of 2nd kidney n function of both kidney. Look for KUB area for any disease. Treat symptomatic GB Stone n cyst of adenexa by surgery n HPR
Exp.laparotomy and excision of cyst with cholecystectomy (proper pre-op counseling for chole)no intervention required for malrotated kidney
I agree with Dr satinder Kumar
Exploratory laparotomy
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