55/F S/P laparoscopic cholecystectomy f/b Re-exploration

 55 year old woman, resident of Narketpally, housewife, came to surgery OPD with pain abdomen since 1 week. 

Known hypertensive since 1 year ( on medication ) 

Known smoker and betal leaf addiction since 20 years.


Patient was apparently asymptomatic 7 days ago when she started developing dull aching type of pain in right upper quadrant radiating to back without any aggravating or relieving factors. Also complaints of constipation since 3 days with non blood stained stools. 

No complaints of fever, vomiting , belching , burning micturation . 

on examination patient was afebrile and conscious and coherent. vitals stable maintaining saturations on room air with only pain abdomen as sole complaint. 

Pre op  reports : 

















Usg abdomen showed cholelithiasis i/v/o which Elective Laparoscopic cholecystectomy was planned on 12th december. 


Post op Hemoglobin readings showed decreasing trends ( fall of 2g/day ) in view of which internal bleeding was suspected and Re exploratory surgery under general anesthesia was done on 15th december 


OT notes:



post op reports







in view of ecg changes ( t wave inversions in all chest leads) medicine opinion was taken



















2d echo showed anterior wall hypokinesia with preserved ejection fraction and patient was started on loop diuretics.


surgery notes : 


diagnosis : Heart failure with preserved ejection fraction. cholelithiasis. S/P laparoscopic cholecystectomy and Re-exploration.
















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