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Dr Rohit Thakur - Surgeon, Pt. JLNGMC&Hospital, Chamba (2026)

30/12/2025

"Gallstone Ileus – Rare but Dangerous"

An elderly patient comes with features of acute intestinal obstruction.
Not cancer. Not adhesions.

A gallstone, silently present for years, slips into the intestine and suddenly blocks it.

This is Gallstone Ileus — rare, deceptive, and dangerous if missed.

High suspicion. Early CT. Timely surgery.
Because sometimes, the smallest stone creates the biggest emergency.

20/12/2025

"The ureter is a tube that doesn't bleed when you cut it, but it makes you cry later."

Kelly’s Sign : - A specific clinical maneuver where a surgeon gently "flicks" or pinches the ureter to elicit a visible vermiculation wave, confirming its identity...!!"

16/12/2025

"A Victory of Courage and Care"

Age is just a number, and determination is everything! We're thrilled to share an inspiring success story from our department today.

A 72-year-old female patient presented with invasive ductal carcinoma (T2N1M0) of the right breast. While Modified Radical Mastectomy (MRM) was the planned treatment, her general health posed a significant challenge.

The concern was managing post-operative pain effectively and safely without compromising her already fragile health.

Thanks to the incredible teamwork between the surgical and anesthesia departments, we found a path forward.
The anesthesia team successfully administered an Erector Spinae Plane (ESP) block—a regional anesthesia technique—specifically for superior post-operative pain relief.

The high-risk MRM was performed successfully! And the best part? The patient’s post-operative period was completely pain-free. She was discharged today, on her 6th post-op day, doing wonderfully!

Note - "Behind every successful surgery is an anesthesia team that makes a difference in safety and comfort".

14/12/2025

One month ago, our 60-year-old patient underwent an exploratory laparotomy to close a jejunal perforation—a major operation.

Last week, he came back in the Casualty with features of acute Intestinal Obstruction due to post-operative adhesions.

For two days, we tried conservative management—trying to get the blockage to settle without surgery. But the symptoms wouldn't budge.
It became clear: we had to go back to the operating theatre (OT).

Intra-operatively, we found the cause: The ileum was densely adherent and jumbled up in the pelvis, creating a critical "transition point" where everything was blocked.
About a 50 cm segment of the small bowel was starting to show gangrenous patches—tissue dying from lack of blood flow.
We had no choice. No taking risk.

we performed a resection—removing that compromised 50 cm segment and reconnecting the healthy ends. It was a precise, high-pressure operation to save the patient's life.

This patient has faced a major health challenge not once, but twice, in a single month.

The patient is now recovering in the ward. The road ahead is still challenging, but we successfully cleared the obstruction and removed the dying tissue.

13/12/2025

"A Rare Breast Tumor in a Teenager – A Reminder to Stay Alert"

A 14-year-old Fch presented to us at Pt JLNGMC Chamba with a rapidly progressive lump in the right breast, measuring approximately 8 × 6 cm.
Given the fast growth and clinical features, a phyllodes tumor was suspected.

FNAC supported the diagnosis, and considering the size and behavior of the lump, we proceeded with a wide local excision, aiming for adequate margins while preserving the breast.
The surgery went smoothly, and the patient is recovering well.

Final histopathology report is awaited, which will guide further management and follow-up.

Key message:-
Rapidly growing breast lumps in adolescents must be evaluated early—age does not rule out serious disease.

13/12/2025

"A Rare Breast Tumor in a Teenager – A Reminder to Stay Alert"

A 14-year-old Fch presented to us at Pt JLNGMC Chamba with a rapidly progressive lump in the right breast, measuring approximately 8 × 6 cm.
Given the fast growth and clinical features, a phyllodes tumor was suspected.

FNAC supported the diagnosis, and considering the size and behavior of the lump, we proceeded with a wide local excision, aiming for adequate margins while preserving the breast.
The surgery went smoothly, and the patient is recovering well.

Final histopathology report is awaited, which will guide further management and follow-up.

Key message:-
Rapidly growing breast lumps in adolescents must be evaluated early—age does not rule out serious disease.

10/12/2025

A Fight Against Adhesions: A Young Life Saved

A 14-year-old boy was rushed to our casualty at Pt JLNGMC Chamba with features of adhesive intestinal obstruction having H/O exploratory laparotomy 3 years back.

We initially managed him conservatively, but after 48 hours there was no improvement. His discomfort, distension and persistent obstruction left us with only one choice — to take him up for surgery.

Intra-operatively, we found a segment of bowel firmly adherent to the abdominal wall forming a clear transition point. The distended bowel was decompressed, adhesions released, and the obstruction relieved.

The procedure went safely and the young boy is now recovering well post-operatively.

Adhesions after abdominal surgeries remain one of the common causes of intestinal obstruction, and timely intervention saves lives.

Saving lives, one emergency at a time...!!

08/12/2025

“Doing a laparoscopic cholecystectomy in such a challenging abdomen is every surgeon’s dream — and we are fortunate enough to turn that dream into reality.”

Precision, patience and perseverance pay off...!!

03/12/2025

"High-risk surgeries reveal courage — both in the surgeon and the patient."

Last week, a 75-year-old malnourished lady was brought to our casualty at Pt JLNGMC Chamba with clear signs of a closed-loop obstruction, and her colon was visibly distended. Diagnosis further confirmed by xray abdomen and CECT abdomen.

Her condition was extremely high-risk due to advanced age, anemia, and very low protein levels, but delaying surgery was not an option.

During surgery (laparotomy):
We discovered a stricture-forming growth in the sigmoid colon, which had caused massive proximal dilation upto caecum — nearly 12 cm. Considering the severity, a Hartmann’s procedure was performed to relieve the obstruction and remove the diseased segment safely.

Post-operative Outcome:
Despite her frail condition, the patient is recovering well. Her strength and willpower continue to inspire us.

This case reminds us that timely intervention, skilled surgical judgment, and coordinated teamwork can save even the most high-risk patients.

28/11/2025

“Paraduodenal hernia - When anatomy surprises, surgeons must be ready".

A 53-year-old male presented in the casualty with clear signs of acute intestinal obstruction. On examination, a firm lump of size app 15*15 cm could be felt on the right side of his abdomen. The suspicion was strong: something unusual was going on inside.

A CT scan confirmed the rare diagnosis—Right Paraduodenal Hernia (incidence < 1%), a condition where a portion of the small intestine slips behind the Waldeyer’s fascia, getting trapped in a hidden pocket. These hernias are uncommon, but when they strike, they can quickly become life-threatening.

Intra op findings —
clustered, dilated bowel loops tightly trapped behind Waldeyer’s fascia.
With careful dissection, we reduced the trapped intestines back to their normal position, excised the sac, and closed the defect to prevent future herniation.

The best part -
His post-operative recovery was completely uneventful. He walked out smiling, relieved and pain-free.

25/11/2025

"Small gallstones are the biggest culprits of pancreatitis — choose surgery, not emergencies.”

Most people think only big gallstones cause trouble. But the truth is — small and multiple gallstones are actually more dangerous.
They can easily slip into the bile duct and trigger acute pancreatitis, a painful and potentially life-threatening condition.

Why timely laparoscopic cholecystectomy matters:
• Prevents gallstone pancreatitis
• Avoids emergency admissions
• Short hospital stay
• Quick recovery
• Safe and effective treatment

If you have gallstones, don’t ignore them.
Consult early. Treat early. Stay safe.

23/11/2025

“Adult intussusception:- uncommon, unexpected, unforgettable in surgery.”

Surgery teaches us: even rare entities deserve rapid recognition.

Dr Rohit Thakur - Surgeon

30/12/2025

20/12/2025

16/12/2025

14/12/2025

13/12/2025

13/12/2025

10/12/2025

08/12/2025

03/12/2025

28/11/2025

25/11/2025

23/11/2025

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