Laparoscopy

Micro laparoscopy is a minimally invasive diagnostic surgical procedure. Laparoscopy enables the surgeon or a gynecologist to directly view the organs of the abdomen and pelvis. Laparoscopy minimizes hospital stay after surgery and recovery period too. Laparoscope is an instrument in the shape of a miniature telescope with a fiber optic system. The laparoscope is a sterile surgical instrument, which has special optics that allows small amounts of light to be transmitted effectively. A laparoscopy involves two cuts approximately 5 -10 cm long. The first cut is below the navel. A hollow needle is inserted. Carbon dioxide gas is pumped into the abdomen through this channel in the laparoscope. This is done to create a space within which the surgeon can look or operate.

The laparoscope is inserted through a second small cut made on the abdomen. The exact position depends upon the procedure that is being conducted. The laparoscope can be moved around within the abdominal or pelvic cavity to give several different views to the operating surgeon. At the end of the procedure, the instruments are removed and the carbon dioxide gas is allowed to escape and the cuts closed with stitches.

• Laparoscopy is used to check infertility. It is used for sterilization in women. It is also used to check ectopic pregnancy, causes of pelvic pain and masses.
  
• Laparoscopy is used to diagnose causes of abdominal pain.
  
• Laparoscopy helps to detect the presence of endometriosis.
  
• The adhesions caused by abdominal scar tissue are separated by laparoscopic procedure.
  
• Laparoscopy can diagnose fibroids.
  
• Ovarian cysts can be identified with a laparoscope.
  
• Laparoscopes assist in vaginal hysterectomy.
  

Bullous Pemphigoid

Bullous Pemphigoid is a very rare skin condition that gives rise to large, fluid-filled blisters. These blisters develop in the area of the skin that can flex, e.g. the armpits, lower abdomen and upper thighs. It can appear in a few areas in the body or can be widespread. One third of the patients develop blisters in their mouth, throat and esophagus apart from the skin. The condition occurs when the body's immune system attacks a thin layer of the tissue below the outer layer of the skin.

Bullous Pemphigoid is a rare occurrence in young adults and children. This condition is common in older people within the age group of 50 to 80. Bullous Pemphigoid is also slightly more common in women than men. Bullous Pemphigoid can get life threatening for older people with poor health. The condition settles down on its own within 5 years. In a few extreme cases, the condition lasts longer. The condition is not infectious and does not spread. Bullous Pemphigoid is commonly seen in the areas of the arms, mouth, groin, legs and abdomen. The exact cause for Bullous Pemphigoid is not clearly known. It is an autoimmune disease.

• Blisters occur due to a problem in the body's immune system.
  
  
• The body produces an antibody against the membrane between the epidermis (top layer of the skin) and the dermis (next layer of the skin) thus leading to the formation of blisters.
  
  
• These blisters are a collection of fluid between the two layers of the skin. Certain medications, light and radiation may also cause the condition.

If the blisters are concentrated around the mucous membranes of your eyes and mouth, then it is called mucous membrane pemphigoid. Blisters on the eyes can lead to scarring.

• Initial symptoms include small patches of itchy skin, pink rashes that resemble eczema.
  
  
• Blisters develop within a week from the appearance of rashes.
  
  
• Blisters are dome shaped and do not break when touched.
  
  
• The fluid in the blister is usually clear or may contain some blood.
  
  
• Blisters commonly appear in the lower abdomen, groin, arms and upper thigh.
  
  
• Blisters appear in the crease/fold of the skin.
  
  
• The number of of blisters may vary, a few areas of the body may get affected or the entire body may get affected.
  
  
• The affected area may get itchy.
  
  
• A few people may develop hives or eczema instead of blisters.

Skin biopsy is done. A blood test may help detect pemphigoid antibodies. This can be detected from urine sample of the person or from the fluid collected in the blister. The common treatment involved in treating Bullous Pemphigoid is aimed at relieving the person from itching and to heal the affected skin. Treatment may include corticosteroids, drugs to fight inflammation and drugs to suppress the immune system.

Hepatomegaly

Hepatomegaly refers to abnormal swelling of the liver. On palpation of the right side of the abdomen, if the liver extends below the ribs, it indicates an enlarged liver. Hepatitis indicates general inflammation of the liver. If both the liver and spleen are enlarged, the condition is called Hepatosplenomegaly.

Possible causes of Hepatomegaly include:

• Fatty Liver
  
• Cirrhosis
  
• Hepatitis
  
• Congestive Heart Failure CHF
  
• Leukemia
  
• Niemann Pick Disease
  
• Primary Biliary Cirrhosis
  
• Reye syndrome
  
• Alcohol Use
  
• Sclerosing Cholangitis (inflammation of bile ducts resulting in scars)
  

Most people suffering Hepatomegaly do not have any noticeable symptoms. Some experience fatigue, loss of appetite, nausea and pain on the right side of the abdomen. Diagnostic tests such as abdominal ultrasound, Liver Function Test and abdomen MRI are suggested.