Amir Bajracharya

Unusual cause for ventriculoperitoneal shunt failure: carcinoma breast compressing distal catheter.

Insertion of a ventriculoperitoneal (VP) shunt is one of the most common surgical procedures in any neurosurgery unit worldwide. Distal catheter obstruction outside the peritoneum is a rare cause of shunt failure. We report the first case of distal obstruction in a 70-year old female by carcinoma breast engulfing the catheter and causing kinking. Intraoperatively, the catheter was intratumoral with no flow of cerebrospinal fluid distally. She underwent relocation of a new catheter to the opposite side of the abdomen and modified mastectomy with resolution of the hydrocephalus. The postoperative course has been uneventful.

Intrauterine omphalic ileal entrapment as an unusual cause of ileal Atresia: Report of a case

We report a case of ileal atresia (IA) caused by an omphalic ring closure anomaly. A 2-day-old male neonate started vomiting bile, accompanied by abdominal distention. Laparotomy revealed that the distal part of the ileum was entrapped within the omphalic ring and that this entrapped segment of ileum was atretic. To our knowledge, this potential mechanism of IA has not been described before.

Idiopathic sclerosing encapsulating peritonitis in an adult male with intermittent subacute bowel obstruction, preoperative multidetector-row CT (MDCT) diagnosis.

Idiopathic sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction that is characterised by a thick greyish-white fibrotic membrane encasing the small bowel. It is difficult to make a definite preoperative diagnosis. We report a successfully treated case of a 42-year-man, presented with sub acute small bowel obstruction caused by SEP. CT showed characteristic findings of small bowel loops congregated to the center of the abdomen encased by a soft-tissue density mantle. He had undergone adhesiolysis and uneventful postoperative period. A high index of clinical suspicion may be generated by the recurrent character of small bowel obstruction combined with relevant imaging findings and lack of other plausible aetiologies. Clinicians must rigorously pursue a preoperative diagnosis, as it may prevent a surprise upon laparotomy and result in proper management.

Giant sacrococcygeal teratoma in an adult: case report.

Congenital sacrococcygeal teratoma (SCT) is the most common germ cell tumour of infancy and childhood. Authors report a case of 18-year -ld female with progressively enlarging sacral mass since birth. MRI showed a solid-cystic mass with no involvement of surrounding structures and it was excised completely by the post-anal route.