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


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
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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