WT. MGM ‘ AG WN BOMBAY HOSPITAL, vasH! NABH ACCREDITED ie enone ISCHARGE SUMMARY ; _ MR. ANANT RAMCHANDRA Namo of Patient: MIRLANANT RA uHID : MGNI180003605 ‘Age! Gender :60 YEARS, @MONTHS/MALE IPNo. : MGMIP2305738 Date of Admission : 28-09-2023 13:46:29 Ward /Bed No. MEPICALWARD UNIT / MW- Date of Discharge: 09-10-2023 13:46:29 Consultants: DR.TUSHAR SONTAKKE Document Ne. : MGMDS2300005701 : : * harge 1YES MGM180003605* Diagnosis : UPPER GASTROINTESTINAL BLEED SECONDARY TO SIGNET CELL MALIGNANT ULCER|SUBACUTE OBSTRUCTION OF BOWEL WITH EXUDATIVE ASCITES IN A KNOWN CASE OF HYPERTENSION, DIABETES MELLITUS Admitted from orp vy Emergency Elective Other Hospital Stay in ICU: YES IfYes Date: From: 28-09-2023 To: 30-09-2023 MLC: NO From: To: From: To: Referrals DR HARSHAD LAHOTI DR PRASHANT ATHALE DR. NINAD TAMBOL! DR PUSHPAK CHIRMADE Presenting Complaints : Presented with complaints of abdominal pain and multiple episodes of vomiting since moming, had 2 episaded of coffee coloured vomiting in emergency room. History | Diagnosis UPPER GASTROINTESTINAL BLEED SECONDARY TO SIGNET CELL MALIGNANT ULCER SUBACUTE OBSTRUCTION OF BOWEL WITH EXUDATIVE ASCITES IN AKNOWN CASE OF HYPERTENSION, DIABETES MELLITUS History of present Illness Presented with complaints of abdominal pain and multiple episodes of vomiting since morning, had 2 episoded of coffee coloured vorniting in emergency room. History of Alcoholism, Denies it Tobaco or Substance abuse Surgical History No any surgery in past Medical History Known case of hypertension, diabetes mellitus Family History Personal History Sleep Bowel & Bladder, Appetite-Normal Previous Medication TABLET LOSAR H, TABLET GLUFLOIN MF, TABLET GLINDA 1 Allergy History NOT KNOWN Examination ; | Pulse 108 per minute iste jOHWard.08IVer.5/24.03.2018 1 of 8 Orem a @ e022 sae aN Sey geet (Spstoency Hotline: 1466 © vestimamesmat cnr net GB wonmornhospitaashinet EQ recre nospitatvessi [G marwashi EE Mad voshMGM : AG NEW BOMBAY HOSPITAL, vas NABH ACCREDITED ce» Sasson ce IARGE SI RY , MR. NANT RAMCHANORA ou os Name of Patient: Sih. eN/nt uHID : MGM180003605 Ago! Gender :60 YEARS, 9MONTHS/MALE —— IPNo. : MGMIP2305738 Date of Admission: 28-09-2023 1:46:29 Ward 1 Bed No. Bio/CAL WARD UNIT / MW- Date of Discharge: 09-10-2028 13:46:29 Consultants: DR.TUSHAR SONTAKKE Document No. : MGMDS2300005701 : . : “ Discharge YES MGM180003605* Diagnosis : UPPER GASTROINTESTINAL BLEED SECONDARY TO SIGNET CELL MALIGNANT ULCER SUBACUTE OBSTRUCTION OF BOWEL WITH EXUDATIVE ASCITES IN A KNOWN CASE OF HYPERTENSION, DIABETES MELLITUS BP 440/90 mm of Hg Height 162 en Weight 78 Ig spo2 {98% on room ait Examination Finding on Admission No Pallorcterus,Cyanosis, lubbing,Lymphadenopathy,Edema Respiratory System-Alr Entry Bllaterally Equal.clear CardioVascular system-Heart sound 1 heard, Heart 2 sound heard, no murmur. Abdomen -Soft, Mliy disteneded No tenderness,No Organomegaiy Central Nervous system- Conscious ,Oriented,No Focal neurological deficit Investigation Laboratory 28/09/23- Haemoglobin-17.Ogm/dL, Total leucocyte count- 9290/cumm, Platelet-400/cumm, Serum sodium-123mEqiL, Serum potassium-4 8mEq/L, Serum chloride- 8,.9mEq/L, Serum Creatinine: 1.1mg/dL., ‘Serum Urea Nitrogen-17 mg/dL, Serum glutanic -oxaloacetic transaminase-27UIL, Serum glutamic pyruvic transaminase- 25U/L, rum Calcium-mgidL., Alkaline Phosphatase-94 UIL, Total Biliubin-1.07mg/dL., Serum Phosphorous. .2mgldL., Uric Acid- ‘gmidl, TotalProteins-8.4g/dl, Serum Albumin-§.0gin/dL, Serum Cholesterol-i35gm/dL, «.sothrombin time -16.70 Intemational normalised ratio -1.20 C’Reactve protein- 4.0 mg/dl ‘Reports Attached 28/09/23- Haemoglobin-14,8gm/dL, Total leucocyte count-8860 /cumm, Platelet-339/eumm, ‘Serum sodium-123mEqj/L, Serum potassium-4.7mEq/L, Serum chloride-01 mEq/L '30/09/23- Haemoglobin-14.4gm/dL, Total leucocyte count-7070 foumm, Platelet-282/eumm. ‘Serum sodium. 129mEqjL, Serum potassium-4.5 mEq/L, Serum chloride- 94mEqiL, Serum Creatinine- 1.2mg/dL. +3/10/23- Haemoglobin-13.8gr/dL, Total leucocyte count-7830 /cumm, Platelet-303/cumm. ‘Serum sodium-126mEq/L, Serum potassium-4, imEq/L, Serum chloride- S2mEqI. Imaging ‘Reports Attached XRAY- Abdomen...multiple ar fuids levels. Others Repor d Histopathology report- Nature of specimen- gastric ulcer biospy impression difuse signet ring ype of gastric carcinoma associated with chronic gastitis-gastric ulcer biospy. : Course in the Hospital © Pick 35, Sector 3, Vashi, Navi MIMEMVARICKA.Ward.09/Ver.5/24.03.2018 2 of 5 @ 2: 022 509957771908 | Tote: 18002665456 | Emergeng Hotline : 14495 © veshimgmegmail.com ontineomamhospitalvashi.net aww.mgmhospitalvashi.net EB vem Hospital veshi GD marveshi EJ mo. veshiMGM 4g" EW BOMBAY HOSPITAL, vast NABH ACCREDITED cee Sten ce DISCHi SUMMAI _ MR. ANANT RAMCHANDRA, Name of Patient: URLONNT HID : MGM180003605 ‘Age! Gender :80 YEARS, 9MONTHS/MALE — IPNo. +: MGMIP2305738, Date of Admission: 28-09-2023 13:46:29 Ward / Bed) Nov it:] es ganas neaeneioas Date of Discharge: 09-10-2023 13:46:29 Consultants: DR.TUSHAR SONTAKKE Document No. : MGMDS2300005701 : Discharge YES *MGM180003605* Diagnosis : UPPER GASTROINTESTINAL BLEED SECONDARY TO SIGNET CELL MALIGNANT ULCER SUBACUTE OBSTRUCTION OF BOWEL WITH EXUDATIVE ASCITES IN A KNOWN CASE OF HYPERTENSION, DIABETES MELLITUS Course in the Hospital Patient presented with mild to moderate abdominal pain since 2-3 months he was investigated he had thickening of transverse. colon and also exudative asicitis he was further planned for diagnostic laproscopy and biopsy but he developed voritig of coffee coloured 8-10 times initially there was food materials present but later started having coffee coloured voriting he had passed ‘motion on admission, ryles tube aspirate was coffee coloured, furter patient was started on PANTOPRAZOLE infusion and antiemetics , antibiotics. patient was seen by Dr. Prashant Athiale who advised conservative management. Patient developed swelling over penis and scrotum, foley's catheter was inserted in view of retention, had bleeding so rapid respone team was called ‘and adviced followed. Reference was given to Dr. Ninad Tamboll and advice was followed. Sample was sent (gastric ulcer biopsy) ‘which was suggestive of gastric carcinoma. Reference given to oncologist Dr. Pushpak Chirmade and adviced for treatment (FLOT). His stay in hospital was uneventful He was clinically stable thus being discharged. Vitals atthe time of discharge- Pulse-80 beats/minute Blood Pressure-130/80 mm of Ha Respiratory Rate-20 breaths/minute Saturation-98% at room air Significant findings- advanced signet cell gastric carcinoma Treatment given in the Hospital -CTION MAGNEX FORTE, SYRUP RELUX, SYRUP SPARACID DS, TABLET LOSAR, INJECTION PERFALGAN, INJECTION 2SET, INJECTION PAN, CAPSULE SOMPRRAZ D ‘surgery / Procedure Details : 4. Surgery / Procedure Name DIAGNOSTIC LAPAROSCOPY WITH PERITONEAL BIOPSY Date & Time 03-10-2023 Surgical Team Time 4:25PM To 5:40PM —AnesthesiaType GA{_ SA | LA Primary Surgeon DR PRSHANT ATHALE Asst.Surgeon DR GAURI KOUNDINYA Intra - op Blood Transfusion NO Anesthetist DR VEENAKULKARNI OT Nurse TANUJA /JHUMA ae is ++ Parietal peritoneum ?deposists ? nodules per rectum biopsy ‘Through marked ports diagnostic laparoscopy done. Ascii taken, Skin ethilon. © Flot 35, Sector 3, Vashi, Navi MiMMEMVAFICHA.Ward.08/Ver.5/24.03.2018 3 of 5 @ ‘ei: (022) 506567777888 | Tollfree : 18002665456 | Emergency Hotline : 14466 © vashimamegmailcom /online@memhospitalvashinet wow.mgmhospitalvashi.net EQ Mo1 Hosp vsti BD mamvessi (EJ MoM. vesn@) sf) = =MGM MG Wt NEW BOMBAY HOSPITAL, VAsHI NABH ACCREDITED ce cSt ce DISCHARGE SUMMARY , MR. ANANT RAMCHANDRA 7 Name of Patient: VANS UHID + MGM180003605 Agel Gender 160 YEARS, 9 MONTHS /MALE IP No. + MGMIP2305738 Date of Admission: 28-09-2023 13:46:29 Ward! Bed No. : MEDICAL WARD UNIT / MU. Date of Discharge: 09-10-2023 13:46:29 Consultants: DR.TUSHAR SONTAKKE Document No. + MGMDS2300005701 : Discharge YES *MGM180003605* agnosis + UPPER GASTROINTESTINAL BLEED SECONDARY TO SIGNET CELL MALIGNANT ULCER SUBACUTE OBSTRUCTION OF BOWEL WITH EXUDATIVE ASCITES IN A. KNOWN CASE OF HYPERTENSION, DIABETES MELLITUS .edications _ Sr.No. Medicines Dose Route Frequency ___—_No. of Days tobe 1 LOSAR 50MG TABLET SO MILLIGRAMS ORALLY Once adayafier TO CONTINUE (LOSARTAN POTASSIUM) 2 TABLETURIMAX 0.6 MILLIGRAMS ORALLY day after. ~~ FOR 10 DAYS dinner 3 ULTRACET 1 TABLET ORALLY ifrequired IF PAIN (37.MG/S25MG)TABLET (TRAMADOL HCL + PARACETAMOL) : ee 4 SYRUP RELUX 2OMILLILITRES ORALLY Once aday after IF CONSTIPATION dinner 5 SOMPRAZD 40MG/30MG 40/30 MILLIGRAMS ORALLY Once a day before | FOR 5 DAYS ‘CAPSULE breakfast (ESOMEPRAZOLE MAGNESIUM + DOMPERIDONE MALEATE) L allow Up Follow-up plan : Follow up with Dr Pushpak Chirmade in outpatient department with prior appointment for chemotherapy (FLOT) Follow up with Dr Prashant Athale 02/10/23 in out patient department for suture removal Nutritional Advice : Salt restricted diabetic diet Do's Take medications regularly “Follow up as per advice, © Piers, Sector 3, Vashi, Navi MAAGMIVIFUONA.Ward.09/Ver.5/24.03.2018 4 of § @ (022) 50656777888 | Toliree: 18002665456 | Emergency Hotline: 14465 © veshimamegmatcom /ontinesmemhospitalvashi net ‘wraw.mgmhospitalvashi.net Ej mn Hospital vashi (G) mamvashi FE] Mm.vashiwT MGM AG" EN BOMBAY HOSPITAL, vast DISCHARGE SUMMARY _ MR. ANANT RAMCHANDRA Name of Patient: Mr. ANANT RA uHID : MGM180003605 Age! Gender 160 YEARS, 9MONTHS/MALE —— IPNo. +: MGMIP230573@ Date of Admission: 26-09-2023 19:46:29 Ward / Bed No. : MEDICAL WARD UNIT / Mvv- Date of Discharge: 09-10-2028 1:46:29 Consultants: DR. TUSHAR SONTAKKE DocumentNo. _ : MGMDS2300005701 : F * Discharge : YES MGM180003605* : UPPER GASTROINTESTINAL BLEED SECONDARY TO SIGNET CELL MALIGNANT ULCER SUBACUTE OBSTRUCTION OF BOWEL WITH EXUDATIVE ASCITES IN A KNOWN CASE OF HYPERTENSION, DIABETES MELLITUS. Others. Report to Emergency in case of : v_ Fever Vv) Nausea and Vomoting v Breathlessness Vv Chest Pain / Any Pain Vv) Bleeding Seizures / Fits Vv Headache / Giddiness / Dizziness Disorientation / Abnormal Behaviour Vv Any Other Symptoms Signature of the Consultant / Registrar Stamp of Consultant” IN CASE OF THE EMERGENCY CONTACT Emergency Department : 022 5066 6888/ 89 Emergency Help Line : 14466 Toll Free 118002665456 Ambulance : 9819460530 IRB © Piet 35, Sector 3, Vashi, Navi MuMBRKVRRTCHA Ward.09/Ver.6/24.03.2018 5 of 5 @ 12: (022 506557777688 1 Toles : 18002665456 | Emergency Hotline: 14455 -vawi.mgmhospitalvashi.net eo vashimgm@gmail.com / online@mgmhospitalvashi.net vom Hospital vsti (BD momvosni (EJ mM ves