Operation

Liver tumor!

This is a 45 year old patient, he had acalculous cholecystitis with a liver tumor covering both the liver and gallbladder. The tumor was filled with pus and almost the size of an American football (ball). This picture presents only about 20% of the actual size of the tumor. The surgery was of a palliative purpose, which included the partial removal of the mass to relieve pain and symptoms. 

Welcome aboard, little one.

The fetal surface of a normal term twin placenta is seen here. The thick dividing membranes between the amniotic cavities occupied by the two fetuses are seen between the cord insertions.

This is a "diamnionic-dichorionic" twin placenta (di-di placenta - where each twin has its own chorionic and amnionic sacs), which makes the likelihood of dizygous twinning much more probable than monozygous twinning. 

Here we are, back with some fractures. This type of fracture is an oblique and displaced fracture, oblique means that the bone breaks diagonally, the break extends in an oblique direction. 

In a displaced fracture, the bone snaps into two or more parts and moves so that the two ends are not lined up straight. 

In the photo, the surgeon tries to realign the bone fracture into its normal position, known as "open reduction". Later on, internal fixation will take place, and will involve a device or an implant that is placed on the bone in order to hold the broken bone together. This is done with screws, plates, rods or pins.

Sick photo following a surgical drainage of a brain abscess. An abscess is the collection of pus that has built up within the tissue of a body, for example inside the brain!!!

Brain or intracranial abscess is caused by an infection, when a bacteria or fungi find their way to the brain. 

intracranial abscesses can originate from infection of contagious structures such as otitis media (ear infection), dental infection, sinusitis and mastoiditis that spreads directly into the brain, or via hematogenous spread from a remote site (like a patient with an infection that causes pneumonia spreading reaching the brain via the blood).

Severe head injury can also allow bacteria or fungi to enter the brain. 

Most of the patients experience a severe headache, mental status changes (confusion), fever, weakness and paralysis. Some may even get seizures. 

Brain abscess is a medical emergency, this is because the swelling caused by the abscess can disrupt the blood and oxygen supply to the brain. 

The most optimal treatment given to the patient includes antimicrobial or antifungal therapy and surgical drainage of the abscess. the procedures used are aspiration through a bur hole and complete excision of the abscess after craniotomy (shown in the photo). 

Leg amputation with a 'fish mouth' flap technique. 

This technique is used mainly for transtibial amputation and above the knee amputations of the lower limbs. The purpose of the skin flaps is to cover the amputated bone and the surrounding structures. 

Fish mouth incision is made distal to the level of the bone transaction, and either an anterior flap can be made so that the scar will be posterior, or two equal anterior and posterior flaps. 

The skin flaps and muscles are then folded up over the end of the bone and are held with sutures, forming a stump. 

Corneal transplant with its stitches still intact and fully visible! 

Cornea transplantation (Keratoplasty) is an operation to remove a damaged or diseased cornea and replace it with healthy donor tissue. 

The cornea is basically the dome-shaped clear surface of your eye which plays an important role in vision, or how well your eye can focus on objects close-up and far away. It helps to focus light rays on to the retina, and the picture is then transmitted to the occipital lobe in the brain. 

The cornea can be damaged through disease, infection, or injury, which results in scarring of the corneal tissue eventually interfering with vision by blocking or distorting light as it enters the eye. 

A cornea transplant is the most common procedure done is such cases. It restores vision to the person with the damaged cornea. Either penetrating (full thickness) cornea transplant or lamellar cornea transplant (selected layers are transplanted from donor) are done, depending on the case. The new cornea is held in place with stitches, which stay in for more than a year.

That sneaky little brain...

A massive blood clot!!! This 80 year-old man experienced nose bleeding for 2 days, he refused to go to the ER. His wife finally convinced him to go the hospital and he coded shortly after arriving, went into a cardiopulmonary arrest. The emergency response team rushed to him trying to intubate the patient and found this huge intact blood clot going all the way from his nose down his airways and into his lungs.

Unilateral cleft lip repair/closure surgery! 

Cleft lip cases tend to be very common nowadays - affects about one in 700 babies annually. it's a birth defect that occurs when a baby's lip do not form properly, causing feeding and speech problems. 

It happens if the tissue that makes up the lip does not join completely before birth. This causes an opening in the upper lip, and in some cases cleft palate (opening in the roof of the mouth) is also present. The opening can be a small slit or a large opening that goes through the lip into the nose. It can be on one (unilateral) or both (bilateral) sides of the lip or, rarely, in the middle of the lip. 

The majority of cases are successfully treated with surgery, in order to achieve proper function and aesthetic quality.