Odysseys of George

A young boy presents with sudden abdominal pain for a duration of 2 days. He was also noted to have progressive abdominal distension and inability to open his bowel or pass flatus. The abdominal pain was progressively worsening and a day prior to admission he was noted to have vomitting. According to the mother he has always had difficulty in passing motion and would require frequent enemas and laxatives to help him open his bowels. He passes very hard stools and at a frequency of once every week. He has had previous episodes of colicky abdominal pain but resolves with laxatives or enemas. This is the first episode of such severe presentation. On examination, revealed a dehydrated, listless child. He had a lowish blood pressure and his plse rate was fast. His abdomen was grossly distended and tender but no evidence of peritonitis. It was resonant on percussion. Per rectal was of empty rectum. This are his abdominal Xray.

and his CT scan

Any takes?

As I walk around town, I am astonished to see the ever growing number of women or ladies puffing about like it was a fashion sense to do so. I wonder why? Why make yourselves look wrinkled and your lips darker then cover it over with thick lipcoat? Why let your skin dry and worn out? Why let yourselves age 10 or maybe 20 times older? Yes initially this changes are inconspicuous but as time, as normally it does last, then these effects become more pronounced and irreversible.

Then again, I don’t actually know why men smoke too but I do hope that the lame excuse of women trying to imitate their male counterpart is not one of them!

Well, as I get more engrossed in photography, I realise that nature is full of subjects to shoot and it is of how creative one is to compose a shot that brings that nature alive. Then there are those who are skillful in their hands and are able to do something creative - a work of art.

During a recent trip to Bali, we were taken to many places among which was a place filled with locally made wood carvings. These are some of the creative works.

My nephew Sherman looking at this carved horse with awe.

And admiring the dolphins too!

and the ducks too.

But Bali had lots to offer which I would soon blog about, my G7 canon had its own story to tell.

One main creative idea that struck me was how one adapts a sling from a child’s play (the catapult) to a nerve wrenching jaw dropping eyeballs rolling adrenaline filled fun game — the Bali Slingshot - where one sits in an open circular structure which spins in its axis and is catapult straight upwards to the dark sky at nerve wrecking speed.

There are more to share especially when one has just arrived from a such a creative island, Bali, but then I will not be able to blog about it.

Just to share before I put up the gory pictures of my busy clinical week. Enjoy these shots and comments are welcomed.

Enjoy

A young boy of 15years old presented with a 2 day history of abdominal pain starting at the upper abdomen(epigastrium) then later the pain was worse felt over the right lower flank. He was diagnosed to have appendicitis.

I got a call from my medical officer saying that he drained 400mls of dark haemoserous fluid from his Lanz incision made for appendectomy. We converted the case to perform a laparotomy and this is what we found.

After releasing the twist,

It is a case of mesenteric venous thrombosis secondary to volvulus of the mid-segment of the small bowel. Maybe also it could be a internal herniation from a congenital band.
After the resection, he is left with probably 90cm of small bowel from about 250 to 300cm of small bowel.

Related post:

What?! This ain’t no appendix

A little late, but have been extremely busy and tired. it has been like this for the last 2 months.
Zanzibar Shrimp(Dasycaris zanzibarica)

Category : Crustaceans
Family : Pontoniinae

A tropical small commensal shrimp species

Distribution: Indo-Pacific region and it has been recorded in Zanzibar, Japan, Philippines, Papua New Guinea, New Caledonia and along the Great Barrier Reef in Australia.

Lives on antipatharian corals (Seawhips / Black coral whips) of the genus Cirripathes in coral reef regions.

Grows to a maximum length of approximately 1cm.

Hope you enjoy this tiny creature.