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Biomedical subjects

V N Bhat

Publications and source records attributed to V N Bhat.

10 recordsLinked to original sources

Unusual presentations of duodenal tuberculosis.

Gastrointestinal tuberculosis is still rampant in underdeveloped countries and can mimic other gastrointestinal (GI) disorders. Herein we report four cases of isolated proximal duodenal tuberculosis, without involvement of other parts of the GI tract. The clinical presentation in three of them resembled that of peptic ulcer disease, and one had features of gastric outlet obstruction. On investigation, one of these patients had a pyeloduodenal fistula. The limitations of clinical evaluation, radiology, and endoscopy are stressed, and the value of surgical biopsy is highlighted.

Adult↗

Ureterocalycostomy for postpyelolithotomy stenosis after failure of intubated infundibuloplasty.

Extended pyelolithotomy for staghorn calculus in a uremic patient with solitary functioning kidney was followed by development of stenosis of the infundibulum draining the superior and middle calyces. Drainage of the lower calyx down the ureter remained intact. Intubated infundibuloplasty proved unsuccessful since scarring and occlusion promptly recurred. Anastomosis of the middle calyx to the ureter was then performed with good results. We believe this is the first reported case of ureterocalycostomy for providing drainage to the middle calyx without lower polar nephrectomy.

Adult↗

Fatal complication of intravesical formalin during control of intractable hemorrhage from radiation cystitis.

Fatal acute tubular necrosis occurred in 1 patient in whom intravesical formalin was used to control massive persistent hemorrhage from radiation cystitis. A suggestion is made to monitor blood formic acid levels and institute prompt dialysis whenever these exceed 80 mg. per 100 ml. to avert such a catastrophe. Intravenous sodium bicarbonate appears to be indicated prophylactically in combating the associated metabolic acidosis due to absorbed formic acid.

Acute Kidney Injury↗

Multiple urethral metastases from prostatic carcinoma causing urinary retention.

A rare case of multiple urethral metastases from adenocarcinoma of prostate causing urinary retention is reported. The unique findings of the urethrogram are described. Transurethral resection provided symptomatic relief. No local recurrence of tumor was observed during the follow-up period of sixteen months.

Adenocarcinoma↗

Blow out of a colocystoplasty loop owing to bladder neck obstruction.

A case of blowout of the colonic segment of a colocystoplasty at its free end owing to late development of bladder neck obstruction is described. Prostatitis and secondary bladder neck contracture provided further hindrance to the already inefficient voiding mechanism and predisposed to the rupture of the decompensated bowel loop. This is an extreme example of proof that the colonic loop, except as an improved substitute for an ileal segment, cannot withstand high intraluminal pressures generated in the presence of bladder outlet obstruction.

Adult↗

Topical or no anaesthesia for external urethral sphincterotomy in neurogenic vesical dysfunction due to spinal injury.

Considerable controversy exists regarding the ideal anaesthetic coverage for external urethral sphincterotomy in spinal injury patients with detrusor-sphincter dyssynergia. From this preliminary experience on 34 patients in whom this procedure was indicated and then attempted under topical (urethral instillation of 20 ml of 2 per cent Lignocaine jelly) or no anaesthesia, we are encouraged into believing that these patients may not require general or regional anaesthesia for this operation.

Aged↗

Uretero-diverticulostomy to provide efficient drainage of pyelocaliceal diverticlum without sacrificing functional renal parenchyma.

Dependent drainage of a lower pole pyelocaliceal diverticulum was achieved by uretero-diverticulostomy in eight patients who already had compromised renal function due to bilateral megaureters or posterior urethral valves. This procedure preserves all functional renal parenchyma and the ureteropelvic junction is left undisturbed. This is the first description of such a procedure for the treatment of lower polar pyelocaliceal diverticulum.

Adolescent↗