Tuesday, February 19, 2008

SWORD (Surgical Ward Round Discussion)

Goh presented a man, which came in with hoarseness of voice and difficulty in breathing on exercition. Thyroid gland is enlarged. Clinically enlarge thyroid with a fix 3x3cm cervical LN and dull on percussion over the sternum. He is also pale with an HB 7.9

Q - "How often thyroid CA cause anemia" - Prof Naqiyah
"
Incidence of bleeding in retrosternal qoitre is higher" - Prof Jasmi

Q - "What other investigation do you need to do for retrosternal goiter" - Prof Naqiyah
A - "CT-Scan, to look for its extension"

Q - "When to operate this patient?" - Prof Ismail

Case 2:
75 year old man presented with RIF pain and guarding

Q - "How common is right sided diverticulitis" - Mr Hanafiah
A - "Local study shows that 1600 pt from the beginning of HUKM, incidence of diverticulitis is 6.2% and right sided diverticulitis is 30%. Majority is still sigmoid colon" - Prof Ismail

Q - "Is the pathology the same with left sided diverticulitis" - Mr Hanafiah
A - "True diverticulum on the right side, which causes more problem" - Prof Ismail

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