โI would break my back for the ones I love , but how many would push the wheelchair for me after ?โ
I think only 3 persons. Iโm lucky as some people will not find anyone beside them.
๐para-ovarian cyst masquerading full bladder ๐in the background lies the processor of flex cystoscopy , where I went into empty bladder and realized this wasnโt a bladder at all , previous us reports said full bladder ๐
Suction tips: turn off suction during navigation of FANS between calyces to avoid pelvicalyceal collapse. Once you reach your target calyx with fragments turn suction on and withdraw the flexible scope to start suction assisted vacum effect with retrieval of fragments
Stone upper calyx with long narrow infundibulum. Kidney is high.
โค๏ธProne supracostal PCNL ( lateral intercostal puncture) above 11th rib at lateral half of the intercostal space, puncture done during expiration. Went well no bleed no pleural injury. 30 minutes complete clearance
@drmostafa961 Assessment the viability of the suspended cap, if it is viable and the stalk provides sufficient perfusion, reanastomosis can be considered.
If it isn't viable and I think that (dusky, blackish ends, no bleeding), excision of the necrotic part & tissue debridement should be done.
@drmostafa961 Assess urethral integrity by urethroscopy/ RGU or simply by passing a urethral cath.
Allow time for natural separation of the amputated part of the galns.
Finally caring of the wound by dressing and broad spectrum antibiotics like Amoxicillin clavulonic acid.
@drmostafa961 Stabilization; ensure that he is vitally stable, pain control with analgesia, sedation may be required for examination and hair removal.
Identify and remove the constricting agent and if incision required avoid urethral injury or neurovascular bundle.
@drmostafa961 Penile tourniquet syndrome with nearly amputation of the glans
due to compromised blood supply.
Also there is a meatus which is mostly a urethrocutaneous fistula.