Liver mets
Yesterday was the mother of all surgery days. We started with 2 pediatric hernias. Next we operated on a lady with a right lower quadrant mass and an enlarged liver. We suspected a cecal cancer with liver mets and, unfortunately, we were exactly correct. We did a right hemicolectomy as the tumor was near obstructing. 

The next patient was an older lady with a large flank bulge. She had a previous surgery and most of her intestines were in a hernia that tracked posteriorly. We repaired this with mesh. Next a submandibular mass which I am sure will be an adenoid cystic carcinoma. The mass was hard as a rock. Then, a woman came in with a fibroid which was prolapsing through the cervix and bleeding. We resected it without a problem.

Next,  a 13 year-old with a large jaw mass. On palpation, the jaw was crackly from the bone being thinned out in areas to less than 1 mm. In other areas, there was no bone! This is probably an ameloblastoma. We had to perform a total right hemimandibulectomy. 

We then placed a chest tube in a man with a pleural effusion. Next we operated on a 21 year-old female who previously had a resection of an ovarian endodermal sinus tumor. She failed to get her followup chemo and now has a recurrence. We found a tumor mass above the bladder. We were able to remove all visible tumor and she will get chemo. 

Finally, we operated on a 25 year-old female with a scalp mass that has been growing for 24 years! We suspected a dermoid cyst. We were correct, as we found, when we accidentally entered the cyst and yellow mush squirted all over the field. There were three of us working on the case and I'm sure each was praying it would be the others that entered the cyst first-LOL!

This is it. I am leaving for Lagos today and then to the USA. We completed 133 cases in 22 days.  Most patients are heading home. There are a few who will be in the hospital for awhile. There is already a list of patients growing for ths next trip. 

Addendum (10/27/11) : Our lady with the dermoid cyst is doing well and discharged. I can't wait for her hair to grow out!